Pharmacology in Structural Intervention for Valvular Heart Disease: Current Practice and Future Perspectives

Over the past 2 decades, structural heart interventions–including procedures like transcatheter aortic valve replacement, transcatheter mitral or tricuspid valve replacement, and transcatheter edge-to-edge mitral or tricuspid valve repair–have emerged as feasible alternatives to traditional surgery for treating valvular heart diseases. Antithrombotic treatment represents a critical aspect of postoperative care, aiming to balance the thromboembolic risk due to the incorporation of prosthetic materials and the consequently altered hemodynamics within the cardiac chambers with the bleeding risk depending on patients’ and procedural factors. This continuously evolving interplay underscores the importance of personalized, evidence-based approaches to ensure optimal outcomes. This review provides a comprehensive examination of the current knowledge on antithrombotic therapies after structural interventions, offering insights into the evolving field and emphasizing the importance of tailored strategies.