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Neth Heart J. 2014 Feb;22(2):64-9. doi: 10.1007/s12471-013-0496-6.

Antithrombotic therapy in patients undergoing TAVI: an overview of Dutch hospitals.

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1
Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435, Nieuwegein, the Netherlands, v.nijenhuis@antoniusziekenhuis.nl.

Abstract

PURPOSE:

To assess current antithrombotic treatment strategies in the Netherlands in patients undergoing transcatheter aortic valve implantation (TAVI).

METHODS:

For every Dutch hospital performing TAVI (n = 14) an interventional cardiologist experienced in performing TAVI was interviewed concerning heparin, aspirin, thienopyridine and oral anticoagulation treatment in patients undergoing TAVI.

RESULTS:

The response rate was 100 %. In every centre, a protocol for antithrombotic treatment after TAVI was available. Aspirin was prescribed in all centres, concomitant clopidogrel was prescribed 13 of the 14 centres. Duration of concomitant clopidogrel was 3 months in over two-thirds of cases. In 2 centres, duration of concomitant clopidogrel was based upon type of prosthesis: 6 months versus 3 months for supra-annular and intra-annular prostheses, respectively.

CONCLUSIONS:

Leaning on a small basis of evidence and recommendations, the antithrombotic policy for patients undergoing TAVI is highly variable in the Netherlands. As a standardised regimen might further reduce haemorrhagic complications, large randomised clinical trials may help to establish the most appropriate approach.

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