‘One-Stop-Shopping’: Safety of Combining Transcatheter Aortic Valve Replacement and Left Atrial Appendage Occlusion

Attinger‐Toller, Adrian; Senn, Oliver; Shakir, Samera; Glöckler, Steffen; Binder, Ronald K.; Stortecky, Stefan; Meier, Bernhard; Nietlispach, Fabiàn

doi:10.1016/s0735-1097(15)61836-8

Cited by 9 publications

(12 citation statements)

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“…A pilot study showed that concomitant TAVI and left atrial appendage closure are feasible and safe 50. The WATCHMAN-TAVR trial (NCT03173534) compares the simultaneous left atrial appendage closure by Watchman implantation and TAVI to TAVI with medical management for AF in 312 patients with a 2-year follow-up.…”

Section: Bleeding Riskmentioning

confidence: 99%

Antithrombotic therapy in patients undergoing transcatheter aortic valve implantation

Nijenhuis

Brouwer

Søndergaard

et al. 2019

Heart

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This review provides a comprehensive overview of the available data on antithrombotic therapy after transcatheter aortic valve implantation (TAVI). In the absence of large randomised clinical trials, clinical practice is leaning towards evidence reported in other populations. Due to the greater risk of major bleeding associated with oral anticoagulation using a vitamin-K antagonist (VKA), antiplatelet therapy (APT) may be considered as the first-line treatment of patients undergoing TAVI. Overall, single rather than dual APT is preferred. However, dual APT should be considered in patients with a recent acute coronary syndrome (ie, within 6 months), complex coronary stenting, large aortic arch atheromas or previous non-cardioembolic stroke. Monotherapy with VKA should be considered if concomitant atrial fibrillation or any other indication for long-term oral anticoagulation is present. APT on top of VKA seems only reasonable in patients with recent acute coronary syndrome, extensive or recent coronary stenting or large aortic arch atheromas. A direct-acting oral anticoagulant may be considered if oral anticoagulation is indicated in the absence of contraindications. Initiation of VKA is indicated in clinical valve thrombosis, for example, with high transvalvular gradient, whereas the role of VKA in the case of subclinical leaflet thrombosis is currently uncertain.

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Section: Bleeding Riskmentioning

confidence: 99%

Antithrombotic therapy in patients undergoing transcatheter aortic valve implantation

Nijenhuis

Brouwer

Søndergaard

et al. 2019

Heart

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“…Based on these encouraging results from LAA closure devices in nonvalvular AF, there is a need for prospective randomized research to assess the efficacy of these devices in patients with valvular AF who are receiving treatment with percutaneous valve replacement. The "one-stop shop" approach of combining percutaneous valve replacement or mitral clipping and LAAO in patients with valvular abnormalities with AF has been shown to be feasible in case reports, 73,74 but needs to be considered in a prospective study to confirm and prove its safety and efficacy.…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Appendage Occlusion: What Are the Options and Where is the Evidence?

Chava

Turagam

Lakkireddy

2018

J Innov Cardiac Rhythm Manage

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“…Atrial fibrillation (AF) occurs in more than 10% of octogenarians, and it is the most common arrhythmia in the TAVI population [55] . In the first PARTNER cohorts, chronic AF was present in 32.9% of inoperable ones [1] and in 40.8% of high-risk patients who underwent TAVI [2] .…”

Section: Left Atrial Appendage Occlusionmentioning

confidence: 99%

Transcatheter aortic valve implantation combined with other heart interventions: current status and future perspectives

Tagliari¹,

Taramasso²

2020

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Transcatheter aortic valve implantation is a well-proven effective treatment option for patients with severe symptomatic aortic valve stenosis requiring valve replacement in all risk classes. Frequently, however, other concomitant cardiovascular conditions demanding intervention are present, and a combined approach is required. Here, we discuss some of the most frequent combined settings. The decision about which approach (staged or simultaneous) is more suitable for each patient needs to be based on individual characteristics and clinical, anatomical, and procedure-related factors.

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‘One-Stop-Shopping’: Safety of Combining Transcatheter Aortic Valve Replacement and Left Atrial Appendage Occlusion

Cited by 9 publications

References 0 publications

Antithrombotic therapy in patients undergoing transcatheter aortic valve implantation

Antithrombotic therapy in patients undergoing transcatheter aortic valve implantation

Left Atrial Appendage Occlusion: What Are the Options and Where is the Evidence?

Transcatheter aortic valve implantation combined with other heart interventions: current status and future perspectives

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