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Mauri et al. Mini-invasive Surg 2022;6:49 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2022.34

Review Open Access

Antithrombotic therapy in patients undergoing

transcatheter aortic valve replacement (TAVR): from
current evidence to perspective

Silvia Mauri 1 , Giuseppe Lanzillo 2 , Marco Ferlini 3

1
Interventional Cardiology Unit, ASST Ovest Milanese, Legnano and Magenta Hospitals, Milano 20013, Italy.
2
Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia 27100, Italy.
3
Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy.
Correspondence to: Dr. Marco Ferlini, Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, viale Golgi 19, Pavia
27100, Italy. E-mail:
marco.ferlini@gmail.com
How to cite this article: Mauri S, Lanzillo G, Ferlini M. Antithrombotic therapy in patients undergoing transcatheter aortic valve
replacement (TAVR): from current evidence to perspective. Mini-invasive Surg 2022;6:49. https://dx.doi.org/10.20517/2574-
1225.2022.34

Received: 8 Apr 2022 First Decision: 7 Jun 2022 Revised: 7 Jul 2022 Accepted: 5 Aug 2022 Published: 1 Sep 2022
Academic Editors: Andrea Scotti, Giuseppe Biondi Zoccai Copy Editor: Jia-Xin Zhang Production Editor: Jia-Xin Zhang

Abstract
The use of transcatheter aortic valve replacement (TAVR) for care of symptomatic severe aortic stenosis has
increased over the last years; after initially treating patients at prohibitive or high surgical risk, nowadays the
procedure can be considered for intermediate or low surgical risk. Although thrombotic events (ischemic stroke,
myocardial infarction, and leaflet thrombosis) decreased in patients at lower risk, antithrombotic therapy after
TAVR is still recommended. However, the optimal antithrombotic regimen is a still matter of debate due to the lack
of randomized data and the concomitant increased risk of bleeding events. In the present review, we analyze
current data, recommendations of international guidelines and consensus documents, and potential future
scenarios with a rational approach of separation of patients with or without a pre-procedural indication for long-
term oral anticoagulant therapy.

Keywords: Antiplatelet, anticoagulant, transcatheter aortic valve replacement

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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