Orale Antikoagulation nach Klappeneingriffen – Was ist der Standard?

Stark, Konstantin und Massberg, Steffen (2022): Orale Antikoagulation nach Klappeneingriffen – Was ist der Standard? In: Aktuelle Kardiologie, Bd. 11, Nr. 5: S. 477-483

Abstract

After interventional procedures of the aortic or the atrioventricular (AV) valves (e.g. TAVI, M-TEER, T-TEER), antithrombotic therapy is recommended. When choosing the optimal antithrombotic regimen, a distinction must be made between patients that have an indication for an oral anticoagulation (OAC) that exists independent of the valve intervention, mostly atrial fibrillation (AF), and patients without such an indication. Several randomized trials have shown that in AF patients receiving TAVI, continuation of OAC (vitamin K antagonists or NOAC) as monotherapy is superior to dual therapy consisting of OAC plus additional anti-platelet therapy. On the other hand, in TAVI patients without preexisting OAC indication, aspirin monotherapy is recommended as postinterventional antithrombotic therapy. After edge-to-edge repair of the mitral and tricuspid valves, continued OAC is recommended if there is a preexisting indication, otherwise aspirin should be prescribed permanently plus clopidogrel for 1-3 months. However, the optimal antithrombotic therapy after interventional repair and replacement of atrioventricular valves has not yet been investigated in larger randomized trials.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2193-5203
• Sprache: Deutsch