In recent years, structural cardiac interventions became an important part of cardiovascular medicine. Despite the rapid development and evolution of these interventional techniques, there is a significant lack of evidence regarding the optimal antithrombotic treatment strategy as randomized trials on this issue are missing for most of these interventions. Thus, this manuscript summarizes the current level of evidence. The listed recommendations are based on available data as well as expert opinion and aim to guide physicians in making decisions for the treatment of patients in this setting.