# Definition, Incidence, Prediction, and Prevention of Bleeding Events After Transcatheter Aortic Valve Implantation

## TL;DR

This review discusses bleeding complications after heart valve implantation, their risks, and strategies to prevent and manage them.

## Contribution

The paper provides an updated analysis of bleeding events and antithrombotic therapy in TAVI patients.

## Key findings

- Major bleeding occurs in 2.0–6.6% of TAVI patients within 30 days.
- Mortality rates are 14.1% at 30 days and 27.8% at one year for major bleeders.
- Preventive strategies include optimized antithrombotic therapy and radial artery access.

## Abstract

Bleeding remains the most common complication following transcatheter aortic valve implantation (TAVI), despite a decline in its incidence over time. Periprocedural (≤30 days) major or life-threatening bleeding is reported to occur in 2.0–6.6% of patients undergoing TAVI. Major bleeding events carry a significant risk of mortality, with rates of 14.1% at 30 days and 27.8% at one year. The timely identification and management of patients at an elevated risk are therefore essential. Preventive measures include optimizing antithrombotic therapies, utilizing ultrasound-guided femoral access, employing single arterial access or a radial artery for secondary access, and administering unfractionated heparin under close monitoring. Long-term follow-up is essential for recognizing and managing late hemorrhages. In this review, we aimed to provide an in-depth analysis of bleeding events associated with TAVI and the most recent updates regarding the antithrombotic therapy of TAVI patients and its clinical impact.