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Spotlight on Evidence Synthesis Program

Comparing Antithrombotic Strategies after Bioprosthetic Aortic Valve Replacement: A Systematic Review

by Dawn Bravata, MD ; Devan Kansagara, MD, MCR ; Joel Papak, MD
Seminar date: 5/21/2018

Description: The use of bioprosthetic aortic valves placed surgically and with a transcatheter approach is a common treatment for valvular heart disease. While most patients are treated with anticoagulant and/or antiplatelet therapy for a period of time after the procedure, the optimal antithrombotic regimen and duration after placement of a bioprosthetic aortic valve is unclear, and both guideline recommendations and practice patterns vary significantly. We will present data from a systematic review of the literature summarizing the comparative benefits and harms for various anticoagulation strategies following surgical or transcatheter implantation of a bioprosthetic aortic valve, and to determine whether effects differed according to thromboembolic risk profile or concomitant procedure. We will also present practice pattern and outcomes data in VA, examining variation in antithrombotic practice across different VA facilities, changes in practice over time, and clinical outcomes after bioprosthetic aortic valve replacement. Review authors: Devan Kansagara, MD, MRC, Joel Papak, MD, and Dawn Bravata, MD. Operational Partner discussants: Marco Zenati, MD, Michele Freeman, MPH and Jacquelyn Quin, MD. Intended audience: clinicians, researchers, and policy makers.

DOWNLOAD: PDF handout | Audio only (mp3) | transcript

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