经导管主动脉瓣置换术后的抗栓治疗策略

Management of antithrombotic therapy in patients undergoing transcatheter aortic valve replacement

经导管主动脉瓣置换术(TAVR)自开展以来发展迅速,随着越来越多临床研究结果的公布,TAVR的适应证已经扩展至全风险范围主动脉瓣狭窄人群。接受TAVR治疗的患者血栓栓塞和出血事件均十分常见,这对TAVR术后的抗栓治疗提出了挑战。而此前的指南关于TAVR的抗栓治疗建议大多基于专家意见而非循证医学证据。本文将基于最近的临床研究探讨TAVR术后抗栓治疗策略的选择。

Transcatheter aortic valve replacement(TAVR)has made rapid progress since its first application.With the availability of more and more clinical evidence,the indications of transcatheter aortic valve replacement have been extended to the full risk range of severe aortic stenosis.Thromboembolic and bleeding complications after TAVR are common,which poses a challenge to the antithrombotic treatment after TAVR.The recommendations of the previous guidelines for the management of valvular heart disease on antithrombotic therapy in patients undergoing TAVR are mostly based on expert opinion rather than clinical evidence.Based on recent clinical studies,this article will provide updated therapeutic insights into the antithrombotic treatment after TAVR.