Optimal Antithrombotic Strategy Following TAVR | Patient Case Quiz
A 68-year-old male presents to clinic complaining of shortness of breath and a recent episode of loss of consciousness with exertion. His past medical history is notable for chest irradiation to treat non-Hodgkin's lymphoma, hypertension, diabetes mellitus, stable coronary artery disease, and prostate cancer, as well as known aortic stenosis (AS). His electrocardiogram demonstrates sinus rhythm with left ventricular hypertrophy with strain. He undergoes a repeat echocardiogram, which demonstrates an aortic valve area of 0.7 cm2 (<1.0 cm2), with an elevated mean transvalvular gradient of 56 mm Hg. Coronary angiography shows non-obstructive epicardial disease. Given the severe symptomatic, high-gradient AS, he undergoes evaluation for intervention by members of the heart valve team who determine he is an appropriate candidate for transcatheter aortic valve replacement (TAVR). He successfully undergoes this procedure without complication.
Following TAVR, which of the following is the optimal antithrombotic strategy for this patient?