TAVR has gained over time a major reduction in procedural complications. Despite this, clinically relevant bleeding still occurs in a non-negligible proportion of patients and adversely affects the prognosis. Patients with severe aortic stenosis are at heightened risk for spontaneous bleeding due to advanced age and a high comorbidity burden. Also, procedural factors and antithrombotic management contribute to define individual bleeding susceptibility.

Bleeding prevention represents an emerging area for improving patient care. Because of the tight hemorrhagic/ischemic balance, a tailored approach based on individual bleeding-risk profile, such as a less invasive antithrombotic regimen or appropriate diagnostic pre-procedural evaluation, should be pursued to avoid bleeding events. This review aims to provide an in-depth overview of bleeding events in the TAVR field, including definitions, timing and the extent of risk, clinical impact as well as updates on antithrombotic management and its potential influence on bleeding complications.

Editors
Editor-in-Chief
Valentin Fuster, MD, PhD, MACC

CME Editor
Ragavendra R. Baliga, MD

Authors
Marisa Avvedimento, MD
Jorge Nuche, MD, PhD
Julio I. Farjat-Pasos, MD
Josep Rodés-Cabau, MD, PhD 

Important Dates
Date of Release: February 13, 2023
Term of Approval/Date of CME/MOC Expiration: February 12, 2024