How Did We Get Here? Antithrombotic Therapy after Bioprosthetic Aortic Valve Replacement: A Review

Abstract: Importance Aortic stenosis is the most common valvular disease, and more than 90% of patients who undergo aortic valve replacement receive a bioprosthetic valve. Yet optimal antithrombotic therapy after bioprosthetic aortic valve replacement remains uncertain, and guidelines provide contradictory recommendations. Observations Randomized studies of antithrombotic therapy after bioprosthetic aortic valve replacement are small and underpowered. Observational data present opposing, and likely confounded, results. Historically, changes to guidelines have not been informed by high-quality new data. Current guidelines from different professional bodies provide contradictory recommendations despite citing the same evidence. Conclusion Insufficient antithrombotic therapy after bioprosthetic aortic valve replacement has serious implications: ischemic stroke, systemic arterial thromboembolism, and clinical and subclinical valve thromboses. Unnecessarily intense antithrombotic therapy, however, increases risk of bleeding and associated morbidity and mortality. Professional bodies have used the current low-quality evidence and generated incongruent recommendations. Researchers should prioritize generating high-quality, randomized evidence evaluating the risks and benefits of antiplatelet versus anticoagulant therapy after bioprosthetic aortic valve replacement.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
How Did We Get Here? Antithrombotic Therapy after Bioprosthetic Aortic Valve Replacement: A Review ; volume:123 ; number:01 ; year:2023 ; pages:006-015
Thrombosis and haemostasis ; 123, Heft 01 (2023), 006-015

Beteiligte Personen und Organisationen
Eikelboom, Rachel
Whitlock, Richard P.
Lopes, Renato D.
Siegal, Deborah
Jaffer, Iqbal H.
Drakos, Paul
Schulman, Sam
Belley-Côté, Emilie P.

DOI
10.1055/s-0042-1758128
URN
urn:nbn:de:101:1-2023022310394806458837
Rechteinformation
Kein Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
14.08.2025, 10:48 MESZ

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Beteiligte

  • Eikelboom, Rachel
  • Whitlock, Richard P.
  • Lopes, Renato D.
  • Siegal, Deborah
  • Jaffer, Iqbal H.
  • Drakos, Paul
  • Schulman, Sam
  • Belley-Côté, Emilie P.

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