In patients with IE, small observational series sug- gest a role for routine neurovascular imaging studies (CT or MRA) to screen for mycotic aneurysms, which can potentially influence the treatment plan.498,499 Further larger studies are needed to determine whether routine neurovascular imaging to screen for mycotic aneurysms in IE improves outcomes. Patients with transcatheter aortic valve replacement and transcatheter mitral valve replacement represent a growing population.500,501 Antiplatelet therapy is the standard antithrombotic regimen after transcatheter aortic valve replacement,33 whereas a combination of oral anticoagulation and antiplatelet therapy has been used with transcatheter mitral valve replace- ment, although with scant supporting evidence.501 At the present time, DOACs are not routinely used in transcatheter aortic valve replacement,502,503 and additional studies are needed to further evaluate the potential benefit of DOACs therapy to prevent isch- emic stroke or TIA in this population. Furthermore, the optimal antithrombotic regimen for patients with a transcatheter aortic valve replacement who have a TIA or ischemic stroke despite adequate antiplatelet therapy is still undefined. 5.4.3. LV Thrombus Recommendations for LV Thrombus Referenced studies that support recommendations are summarized in online Data Supplement 35. COR LOE Recommendations In patients with stroke or TIA and LV thrombus, anticoagulation with therapeutic warfarin for at least 3 months is recommended to reduce the risk of recurrent stroke.504 508 In patients with stroke or TIA in the setting of acute MI, it is reasonable to perform advanced cardiac imaging (eg, contrasted echocar- diogram or cardiac MRI) to assess for the presence of LV thrombus. 