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Kawashima H, Numasawa Y, Hayakawa N, Asano T, Tanaka S, Torii S, Ueshima D, Hishikari K, Hioki H, Watanabe Y, Mizutani K, Matsuo Y, Hayashida K, Jujo K, Nakazawa G. Review of Bleeding and Thrombotic Risks Associated With Antithrombotic Therapy After Transcatheter Structural Heart Interventions. JACC Asia 2024; 4:1-9. [PMID: 38222261 PMCID: PMC10782401 DOI: 10.1016/j.jacasi.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 01/16/2024]
Abstract
Transcatheter structural heart interventions have drastically evolved over the past 2 decades. However, most catheterization procedures require the deployment of devices in the body; therefore, the adhesion of thrombi to those devices is a major problem, resulting in the requirement of a period of postprocedural antithrombotic regimen. However, in recent years, bleeding associated with these antithrombotic therapies has also become a major concern, attracting the attention of investigators. This is complicated by the fact that patients at high thrombotic risk are also at high bleeding risk, making the issue of administrating antithrombotic therapy challenging. The objective of this review was to identify the important issues and summarize the current status of postoperative antithrombotic therapy and assessment of the bleeding risk following transcatheter structural heart interventions such as transcatheter aortic valve replacement, transcatheter edge-to-edge repair, and transcatheter left atrial appendage occlusion.
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Affiliation(s)
- Hideyuki Kawashima
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Yohei Numasawa
- Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Asahi, Japan
| | - Taku Asano
- Department of Cardiovascular Medicine, St. Luke’s International Hospital, St. Luke's International University, Tokyo, Japan
| | - Shigemitsu Tanaka
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Sho Torii
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Daisuke Ueshima
- Department of Cardiology, Kameda Medical Center, Kamogawa, Japan
| | - Keiichi Hishikari
- Department of Cardiology, Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Hirofumi Hioki
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuki Mizutani
- Department of Cardiology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yae Matsuo
- Department of Cardiovascular Medicine, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shibukawa, Gunma, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Jujo
- Department of Cardiology, Saitama Medical University/Saitama Medical Center, Saitama, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Kindai University Faculty of Medicine, Osaka, Japan
| | - SUNRISE Lab Investigators
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
- Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan
- Department of Cardiovascular Medicine, Asahi General Hospital, Asahi, Japan
- Department of Cardiovascular Medicine, St. Luke’s International Hospital, St. Luke's International University, Tokyo, Japan
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
- Department of Cardiology, Kameda Medical Center, Kamogawa, Japan
- Department of Cardiology, Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan
- Department of Cardiology, Kindai University Faculty of Medicine, Osaka, Japan
- Department of Cardiovascular Medicine, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shibukawa, Gunma, Japan
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
- Department of Cardiology, Saitama Medical University/Saitama Medical Center, Saitama, Japan
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