Transcatheter aortic valve replacement (TAVR) has proven to be an effective treatment option for patients with severe aortic stenosis at intermediate-high risk for complications with surgical aortic valve replacement. In spite of the growing popularity of TAVR, the optimal antithrombotic regimen remains unknown. This blog outlines current guideline recommendations for post-TAVR antithrombotic therapy and gives guidance on how to handle special populations and patient-specific factors.
One of the questions that remained unanswered after the PARADIGM-HF trial was whether the angiotensin receptor/neprilysin inhibitor sacubitril/valsartan could be safely initiated in patients with acute decompensated heart failure who had been previously stabilized on an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker. In this blog, Dr. Reed discusses the implications of the PIONEER-HF and TRANSITION studies, and provides a practical strategy for transitioning patients to sacubitril/valsartan.