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Scientific paper - Review paper
Antitrombotska terapija u bolesnika podvrgnutih transkateterskoj implantaciji aortalnog zaliska
Medicina Fluminensis : Medicina Fluminensis, 60 (2024), 2; 145-152. https://doi.org/10.21860/medflum2024_316226
Lulić, Davorka; Košak, Luka; Bačić, Gordana; Miovski, Zoran; Jakljević, Tomislav; Tomulić, Vjekoslav

Institutional repository: Repository of the University of Rijeka, Faculty of Medicine

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Lulić, D., Košak, L., Bačić, G., Miovski, Z., Jakljević, T. & Tomulić, V. (2024). Antitrombotska terapija u bolesnika podvrgnutih transkateterskoj implantaciji aortalnog zaliska. Medicina Fluminensis : Medicina Fluminensis, 60. (2), 145-152. doi: 10.21860/medflum2024_316226

Lulić, Davorka, et al. "Antitrombotska terapija u bolesnika podvrgnutih transkateterskoj implantaciji aortalnog zaliska." Medicina Fluminensis : Medicina Fluminensis, vol. 60, no. 2, 2024, pp. 145-152. https://doi.org/10.21860/medflum2024_316226

Lulić, Davorka, Luka Košak, Gordana Bačić, Zoran Miovski, Tomislav Jakljević and Vjekoslav Tomulić. "Antitrombotska terapija u bolesnika podvrgnutih transkateterskoj implantaciji aortalnog zaliska." Medicina Fluminensis : Medicina Fluminensis 60, no. 2 (2024): 145-152. https://doi.org/10.21860/medflum2024_316226

Lulić, D., et al. (2024) 'Antitrombotska terapija u bolesnika podvrgnutih transkateterskoj implantaciji aortalnog zaliska', Medicina Fluminensis : Medicina Fluminensis, 60(2), pp. 145-152. doi: 10.21860/medflum2024_316226

Lulić D, Košak L, Bačić G, Miovski Z, Jakljević T, Tomulić V. Antitrombotska terapija u bolesnika podvrgnutih transkateterskoj implantaciji aortalnog zaliska. Medicina Fluminensis : Medicina Fluminensis [Internet]. 2024 June 01 [cited 2024 July 13];60(2):145-152. doi: 10.21860/medflum2024_316226

D. Lulić, L. Košak, G. Bačić, Z. Miovski, T. Jakljević and V. Tomulić, "Antitrombotska terapija u bolesnika podvrgnutih transkateterskoj implantaciji aortalnog zaliska", Medicina Fluminensis : Medicina Fluminensis, vol. 60, no. 2, pp. 145-152, June 2024. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:184:421514. [Accessed: 13 July 2024]

Metadata
Title (croatian)Antitrombotska terapija u bolesnika podvrgnutih transkateterskoj implantaciji aortalnog zaliska
Title (english)Antithrombotic Therapy after the Transcatheter Aortic Valve Implantation
AuthorDavorka Lulić
AuthorLuka Košak
AuthorGordana Bačić
AuthorZoran Miovski
AuthorTomislav Jakljević
AuthorVjekoslav Tomulić
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Internal Medicine)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Abstract (croatian)
Aortalna stenoza (AS) najčešća je primarna valvularna bolest srca. Teška simptomatska aortalna stenoza indikacija je za liječenje kirurškim ili perkutanim putem. Transkateterska implantacija aortalnog zaliska (engl. transcatheter aortic valve implantation; TAVI) perkutana je metoda koja se unatrag 20 godina koristi kod velikog broja bolesnika, sukladno odluci konzilija (engl. Heart Team). Period tijekom i nakon zahvata od izrazite je važnosti kako bi se spriječio nastanak tromboembolijskih komplikacija. 7 % bolesnika nakon TAVI zahvata u prvih 12 mjeseci doživi ishemijski moždani udar. Postproceduralno, uzrok moždanog udara najčešće je posljedica novonastale fibrilacije atrija ili tromboze bioproteze. Antitrombotska terapija je terapija izbora za prevenciju nastanka tromboembolijskog incidenta nakon TAVI zahvata. Istovremeno, potrebno je obratiti pažnju na moguće jatrogene komplikacije poput krvarenja u ranom poslijeoperacijskom periodu. Vrsta antitrombotske terapije nakon TAVI zahvata razlikuje se s obzirom na prisutnost kronične antikoagulantne terapije. U bolesnika bez indikacije za kroničnu antikoagulantnu terapiju acetilsalicilna kiselina je lijek izbora, dok u bolesnika s indikacijom za antikoagulantnu terapiju, oralni antikoagulansi pokazali su se sigurnima. Trombocitopenija je česta komplikacija nakon TAVI zahvata. U tih bolesnika ili u onih s prisutnom trombocitopenijom prije zahvata, vrsta i trajanje antitrombotske terapije ovisi o težini trombocitopenije te se prilagođava bolesniku u dogovoru multidisciplinarnog tima kardiologa i hematologa s obzirom na kombinirani ishemijski rizik i rizik od krvarenja.
Abstract (english)
Aortic stenosis (AS) is the most common primary valvular heart disease. Severe symptomatic aortic stenosis should be treated surgically or percutaneously. Transcatheter aortic valve implantation (TAVI) is a percutaneous method that has become a choice of treatment in many patients in the past 20 years, according to the decision of the Heart Team. The period during and after the procedure is extremely important to prevent the onset of thromboembolic complications. 7% of patients experience an ischemic stroke in the first 12 months after the TAVI procedure. Postprocedurally, the stroke is most often caused by new atrial fibrillation onset or thrombosis of the bioprosthesis. Antithrombotic therapy is the therapy of choice for preventing thromboembolic events after the TAVI procedure. On the other hand, iatrogenic bleeding complications can occur in the early postoperative period. The type of antithrombotic therapy after the TAVI procedure differs depending on the presence of chronic anticoagulant therapy. In patients without an indication for chronic anticoagulant therapy, acetylsalicylic acid is the drug of choice, while in patients with an indication for anticoagulant therapy, oral anticoagulants should be prescribed. Thrombocytopenia is a common complication after TAVI. In these patients or in those with chronic thrombocytopenia, the type and duration of antithrombotic therapy depend on the severity of thrombocytopenia. Those patients should be discussed with the multidisciplinary team of cardiologists and hematologists, taking into consideration ischemic and bleeding risks.
Keywords (croatian)
Keywords (english)
Languagecroatian
Languageenglish
Publication typeScientific paper - Review paper
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleMedicina Fluminensis : Medicina Fluminensis
Numberingvol. 60, no. 2, pp. 145-152
p-ISSN1847-6864
e-ISSN1848-820X
DOIhttps://doi.org/10.21860/medflum2024_316226
URN:NBNurn:nbn:hr:184:421514
Publication2024-06-01
Document URLhttps://hrcak.srce.hr/316226
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution 4.0 International (CC BY 4.0) icon
Created on2024-06-06 07:38:44