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Víctor Alfonso Jiménez Díaz: SAPT or DAPT in Valve-in-Valve TAVI? Walking a Fine Line
Dec 23, 2025, 05:23

Víctor Alfonso Jiménez Díaz: SAPT or DAPT in Valve-in-Valve TAVI? Walking a Fine Line

Víctor Alfonso Jiménez Díaz, Director, Cardiovascular Research Unit, Hospital Álvaro Cunqueiro at Hospital Álvaro Cunqueiro, University Hospital Complex of Vigo, shared a post on LinkedIn:

“SAPT or DAPT in Valve-in-Valve TAVI? Walking a Fine Line

Víctor Alfonso Jiménez Díaz: SAPT or DAPT in Valve-in-Valve TAVI? Walking a Fine Line

Antithrombotic therapy after TAVI remains one of the most complex challenges in structural heart interventions. Although the POPular TAVI trial shifted the balance toward single antiplatelet therapy (SAPT) in the general population, can we apply the same logic to Valve-in-Valve (ViV) procedures?

We have just published our editorial comment in JACC: Cardiovascular Interventions: “Still Walking a Fine Line,” where we analyze the interesting study by Bendandi et al. on the use of SAPT vs. DAPT in ViV procedures.

Why is the ViV scenario different?
-In ViV, altered anatomy and hemodynamic limitations can amplify thrombotic risk.
-Evidence from native TAVI is not always extrapolable to patients with failed bioprostheses.
-The balance between bleeding risk and leaflet thrombosis is, now more than ever, a “fine line.”
This editorial highlights the urgent need for subgroup-specific data and individualized decision-making.

Congratulations to my colleague Cláudio Espada Guerreiro for this analysis and to Francesco Bendandi, Palmerini Tullio, Federico De Marco, Cosmo Godino, Chiara Fraccaro, Marco Barbanti, francesco maisano, Francesco Saia and the entire Italian team for the original research.

Read the full editorial here

Title: Dual vs Single Antiplatelet Therapy After Valve-in-Valve TAVR: Still Walking a Fine Line

Authors: Victor Alfonso Jimenez Diaz, Claudio Guerreiro

Víctor Alfonso Jiménez Díaz: SAPT or DAPT in Valve-in-Valve TAVI? Walking a Fine Line

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