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Stroke prevention during and after transcatheter aortic valve implantation: From cerebral protection devices to antithrombotic management

Authors :
Victor Alfonso Jimenez Diaz
Rodrigo Estevez Loureiro
Jose Antonio Baz Alonso
Pablo Juan Salvadores
Guillermo Bastos Fernandez
Berenice Caneiro Queija
Cesar Veiga Garcia
Andres Iñiguez Romo
Source :
Frontiers in Cardiovascular Medicine, Vol 9 (2022)
Publication Year :
2022
Publisher :
Frontiers Media S.A., 2022.

Abstract

Since its conception, transcatheter aortic valve implantation (TAVI) has undergone important improvements both in the implantation technique and in transcatheter devices, allowing an enthusiastic adoption of this therapeutic approach in a wide population of patients previously without a surgical option and managed conservatively. Nowadays, patients with severe symptomatic aortic stenosis are typically managed with TAVI, regardless of their risk to surgery, improving the prognosis of patients and thus achieving an exponential global expansion of its use. However, thromboembolic and hemorrhagic complications remain a latent concern in TAVI recipients. Both complications can appear simultaneously in the periprocedural period or during the follow-up, and when minor, they resolved without apparent sequelae, but in a relevant percentage of cases, they are devastating, overshadowing the benefit achieved with TAVI. Our review outlines the etiology and incidence of thromboembolic complications associated with TAVI, the main current strategies for their prevention, and the implications of its pharmacological management at the follow-up in a TAVI population, mostly frail and predisposed to bleeding complications.

Details

Language :
English
ISSN :
2297055X
Volume :
9
Database :
Directory of Open Access Journals
Journal :
Frontiers in Cardiovascular Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.102a751008b4d85a18bf80f7265f6a1
Document Type :
article
Full Text :
https://doi.org/10.3389/fcvm.2022.958732