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Antithrombozytäre oder antikoagulative Strategie nach chirurgischer/interventioneller Klappenbehandlung

Antiplatelet or anticoagulative strategies after surgical/interventional valve treatment

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Zusammenfassung

Ende August 2017 publizierte die europäische kardiologische Gesellschaft (European Society of Cardiology, ESC) gemeinsam mit der europäischen Gesellschaft für Herz- und thorakale Gefäßchirurgie (European Association for Cardio-Thoracic Surgery, EACTS) neue Leitlinien zur Behandlung von Klappenerkrankungen. Diese Leitlinien berücksichtigen neue wissenschaftliche Erkenntnisse, die seit der letzten Leitlinienversion 2012 verfügbar sind. Diese Übersichtsarbeit berichtet über die aktuellen Empfehlungen zur antithrombozytären und antikoagulativen Therapie nach chirurgischer/interventioneller Behandlung der Aorten- und Mitralklappe und diskutiert die zugrunde liegende wissenschaftliche Evidenz.

Abstract

At the end of August 2017 the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) published new joint guidelines for the treatment of valvular heart disease. These guidelines incorporate the scientific progress since the last version of the guidelines published in 2012. This article reviews current guideline recommendations for antiplatelet and anticoagulative therapy after surgical/interventional treatment of the aortic and mitral valves and discusses the underlying scientific evidence.

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Abb. 1

Abbreviations

ACTION:

Anticoagulation Treatment Influence on Postoperative Patients

ATLANTIS:

Anti-Thrombotic Strategy after Trans-Aortic Valve Implantation for Aortic Stenosis

AVERA:

Multicenter Randomized Comparison of Low-Dose Versus Standard-Dose Anticoagulation in Patients with Mechanical Prosthetic Heart Valves

GALILEO:

Global Study Comparing a Rivaroxaban-Based Antithrombotic Strategy to an Antiplatelet-Based Strategy after Transcatheter Aortic Valve Replacement to Optimize Clinical Outcomes

GELIA:

German Experience with Low Intensity Anticoagulation

ISAR-TRIPLE:

Intracoronary Stenting and Antithrombotic Regimen-Testing of a Six-Week versus a Six-Month Clopidogrel Treatment Regimen in Patients with Concomitant Aspirin and Oral Anticoagulant Therapy Following Drug-Eluting Stenting

PROACT:

Prospective Randomized On-X Anticoagulation Clinical Trial

RESOLVE:

Assessment of Transcatheter and Surgical Aortic Bioprosthetic Valve Thrombosis and its Treatment with Anticoagulation

SAVORY:

Subclinical Aortic Valve Bioprosthesis Thrombosis Assessed With 4D CT

TAVI:

„Transcatheter aortic valve implantation“, kathetergeführter perkutaner Aortenklappenersatz

VKA:

Vitamin-K-Antagonist

WOEST:

What is the Optimal Antiplatelet and Anticoagulant Therapy in Patients with Oral Anticoagulation and Coronary Stenting

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Authors and Affiliations

  1. Medizinische Klinik II, Universitäres Herzzentrum Lübeck, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    A. Jobs,  T. Stiermaier &  I. Eitel

  2. Klinik für Herz- und thorakale Gefäßchirurgie, Universitäres Herzzentrum Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland

    S. Klotz

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A. Jobs, T. Stiermaier, S. Klotz und I. Eitel geben an, dass kein Interessenkonflikt besteht.

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Jobs, A., Stiermaier, T., Klotz, S. et al. Antithrombozytäre oder antikoagulative Strategie nach chirurgischer/interventioneller Klappenbehandlung. Herz 43, 26–33 (2018). https://doi.org/10.1007/s00059-017-4646-2

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