DAPT After Valve-in-Valve TAVI – Debate Continues Source: Medscape | Oct 14, 2025 — Based on JACC study
DAPT After Valve-in-Valve TAVI – Debate Continues
Source: Medscape | Oct 14, 2025 — Based on JACC study
Types of TAVI:
• Native TAVI: replaces the patient’s own calcified aortic valve.
• Valve-in-Valve (ViV): new valve inside a failed surgical bioprosthetic valve.
• Redo TAVI (TAVI-in-TAVI): new valve inside a failed transcatheter valve.
Key Summary
• Guidelines: Single antiplatelet (aspirin) or anticoagulant if indicated — per POPular-TAVI trials (2020).
• Rationale: ViV cases have higher thrombosis risk due to slow flow and under-expansion between valve frames.
• Study: 278 ViV-TAVI patients (10 Italian centers) compared DAPT vs SAPT; AF patients excluded.
• Findings: Slight stroke reduction with DAPT; similar bleeding; data too limited to change current single-therapy practice.
• Conclusion: Single antiplatelet therapy remains the standard pending larger trials.