Management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation Survey

1.Let's focus on the consensus document of the ESC Working Group on Thrombosis and the European Association of Percutaneous Cardiovascular Interventions (EAPCI), in collaboration with the ESC Council on Valvular Heart Disease on the management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation?

How familiar are you with this consensus document? (If necessary see abstract at the bottom of this page)

Not familiar at all

Heard of it

Read it

Read it and follow recommendations

2.Which treatment do you prescribe in patients treated with TAVI with no indication for oral anticoagulation and no PCI within 3 months?
Select one

ASA only

Clopidogrel only

DAPT (ASA with clopidogrel)

OAC to prevent valve thrombosis

3.In CCS patients under chronic OA and treated with PCI less than 3 months before, what would be your choice in terms of anti-platelet treatment duration post-TAVI?

4.In your opinion what is the main goal of the use of antiplatelet medication after TAVI? Select one

Reduction of stroke risk

Reduction of valve thrombosis

Both

5.In patients on chronic OAC undergoing transfemoral TAVI do you routinely stop the OAC before procedure? Select one

Yes

Yes, with LMWH bridging

No

6.In patients with OAC undergoing TAVI, when do you prescribe aspirin? Select one

Never

In case of PCI concomitant to or within 30 days after TAVI

In case of diagnosed CAD, in case of history of PCI at any time

7.From a physician perspective, and as a side question within this survey, we kindly ask you to provide your feedback on this last query.

Are there female interventional cardiologists or cardiac surgeons involved in the your TAVI team? Please select one or more of the following options.

No

Yes, only as second operators (e.g. as they are still early carrer internventionalists)

Yes, fully integrated in the TAVI team, also as first independent operators

Yes, only as second operators (e.g. as they are still early carrer cardiac surgeons)

Yes, fully integrated in the TAVI team, also as first independent cardiac surgeon operators

9.Please select your gender

Female

Male

Other

Do not want to say

10.Which of the following best describes your primary workplace? Select all that apply.

Other (please specify)

11.Which best describes your profession?

Other (please specify)

12.In which country do you currently practice?

ABSTRACT

Management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation: a consensus document of the ESC Working Group on Thrombosis and the European Association of Percutaneous Cardiovascular Interventions (EAPCI), in collaboration with the ESC Council on Valvular Heart Disease
Jurrien ten Berg, Dirk Sibbing, Bianca Rocca, Eric Van Belle, Bernard Chevalier, Jean-Philippe Collet, Dariusz Dudek, Martine Gilard, Diana A Gorog, Julia Grapsa, Erik Lerkevang Grove, Patrizio Lancellotti, Anna Sonia Petronio, Andrea Rubboli, Lucia Torracca, Gemma Vilahur, Adam Witkowski, Julinda Mehilli
European Heart Journal, Volume 42, Issue 23, 14 June 2021, Pages 2265–2269

Abstract
Transcatheter aortic valve implantation (TAVI) is effective in older patients with symptomatic severe aortic stenosis, while the indication has recently broadened to younger patients at lower risk. Although thromboembolic and bleeding complications after TAVI have decreased over time, such adverse events are still common. The recommendations of the latest 2017 ESC/EACTS Guidelines for the management of valvular heart disease on antithrombotic therapy in patients undergoing TAVI are mostly based on expert opinion. Based on recent studies and randomized controlled trials, this viewpoint document provides updated therapeutic insights in antithrombotic treatment during and after TAVI.

Antithrombotic treatment during and after transcatheter aortic valve implantation. The figure summarizes the consensus for treating patients who are candidate for transcatheter aortic valve implantation, according to the presence or absence of oral anticoagulation indications and to recent coronary stenting. ACT, activated clotting time; ASA, aspirin; DAPT, dual antiplatelet therapy; HIT heparin-induced thrombocytopenia; NOAC, non-vitamin-K antagonist oral anticoagulant; OAC, oral anticoagulation; SAPT, single antiplatelet therapy; TAVI, transcatheter aortic valve implantation; VKA, vitamin K antagonist. *Low-dose aspirin or clopidogrel. #Bivalirudin if heparin-induced thrombocytopenia. @Duration according to bleeding risk.