Theodora Bampali

University Hospital of Ioannina, Greece

Title: The optimal antithrombotic therapy after transcatheter valve interventions. The less the merrier.

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Biography

Theodora Bampali  is a Cardiologist. The last 3 years I work as a Consultant in Cardiac Surgery Department of Ioannina University Hospital, in NW Greece. In 2021 I passed the European Examination on Core Cardiology. I am Sub-investigator in 6 recent Clinical trials related to thrombosis and heart failure and member of several WG under the aspects of European Society of Cardiology. I have authored/co-authored 9 papers the last 2 years, published in Pubmed. I am invited speaker in more than 20 congresses the last 5 years.

My main field of interest, and also the theme of my Msc is the antithrombotic therapy in valvular disease, both in native valves and in surgical or transcatheter treated, and specifically in complex patients with several comorbidities that interfere with their thrombotic and bleeding phenotype. I treat more than 100 patients per month during hospitalization and in outpatient clinic.

Abstract

Since the late 2000’s, TAVR has led to constant improvement in clinical outcomes with the development of techniques and technological ameliorations along with increased operator experience. Over time the philosophy of non-surgical intervention extended to the other valves i.e., mitral valve and tricuspid valve. This target group of the patients have multiple comorbidities and subsequently high surgical risk. Amongst other, atrial fibrillation, concomitant coronary disease treated with stenting, peripheral artery disease, or stroke augment the innate thrombotic risk of these patients and the need for combined antithrombotic therapy rises. On the other hand, advanced age, frailty, anemia, thrombocytopenia, chronic kidney disease increase the bleeding risk and suspend the combination and duration of the antithrombotic therapy. The current guidelines suggest that the optimum antithrombotic therapy must be personalized. After the Galileo OAC trial OACs are ostracized if there is not atrial fibrillation. Nevertheless, these guidelines carry a LoE B or C, so there are a lot of gaps in the literature and more trials are awaited. The purpose of my speech is to guide through the current bibliography via clinical scenarios, in order to clarify the optimal antithrombotic therapy after transcatheter valve interventions.