Antithrombotic Therapy for Transcatheter Valvular Interventions: A Revisit

Mohammed, Shaban; El‐Menyar, Ayman; Al-Janubi, Haifa; Shabana, Adel; Alanazi, Zaid

doi:10.2174/1570161115666170406105753

Cited by 1 publication

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“…Although this rationale might seem insufficient to offset cardiac surgery stroke risk, it may embody the recommendation for anticoagulation, particularly with vitamin K antagonists, which are the only oral anticoagulants indicated in both mitral prosthesis and mitral stenosis 9 . Despite this, no strict peri-and post-MitraClip procedure antithrombotic therapies have been defined so far; distinct protocols are currently being applied 10,11 .…”

Section: Introductionmentioning

confidence: 99%

Stroke after transcatheter edge-to-edge mitral valve repair: a systematic review and meta-analysis

Silva¹,

Sousa²,

Oliveiros³

et al. 2020

EuroIntervention

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Aims:The aim of this study was to assess the stroke rate after transcatheter mitral valve repair (TMVR) with the MitraClip, comparing it with surgical mitral valve repair (SMVR) and optimal medical treatment (OMT). Methods and results:In December 2018, we systematically searched PubMed, Embase and Cochrane Controlled Register of Trials for studies comparing TMVR with SMVR and/or OMT for the treatment of severe mitral regurgitation. Random-effects and cumulative meta-analysis was performed. Ten studies were included (seven of TMVR versus SMVR and three of TMVR versus OMT), providing a total of 1,881 patients and 61 pooled strokes (16 in TMVR versus SMVR and 45 in TMVR versus OMT). There was no difference in stroke incidence between TMVR and SMVR (pooled OR 0.49 [0.17, 1.42], p=0.19). However, there was a trend towards a lower stroke risk in TMVR. For TMVR versus OMT, no difference in stroke rate was identified (pooled OR 1.09 [0.60, 1.97], p=0.79). Post-procedure de novo atrial fibrillation was more frequent in SMVR when compared with TMVR.Conclusions: Despite both a low number of pooled stroke events and the failure to reach the pre-specified statistical significance, there was a trend for a lower post-procedure stroke rate in TMVR when compared with SMVR and a similar one between TMVR and OMT alone.

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Section: Introductionmentioning

confidence: 99%