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Pathologic confirmation of valve thrombosis detected by four-dimensional computed tomography following valve-in-valve

Ambarish Gopal1, Nathalia Ribeiro1, John J Squiers1

  • 1The Heart Hospital Baylor Plano, 4716 Alliance Blvd, Suite 340, Plano, TX 75093, USA.

Global Cardiology Science & Practice
|April 13, 2018
PubMed

Insights

Leaflet thrombosis is a concern after transcatheter aortic valve replacement (TAVR). This study provides the first pathologic confirmation of TAVR leaflet thrombosis identified by four-dimensional computed tomography (4D-CT) in a surgically explanted valve from a surviving patient.

Area of Science:

  • Cardiovascular Imaging
  • Cardiac Surgery
  • Pathology

Background:

  • Leaflet thrombosis is a significant complication following transcatheter aortic valve replacement (TAVR).
  • Four-dimensional computed tomography (4D-CT) is the primary imaging technique for diagnosing suspected TAVR leaflet thrombosis.
  • Pathologic confirmation of 4D-CT findings in surviving patients has been lacking.

Observation:

  • This study presents a unique case of a surgically explanted TAVR prosthesis.
  • The explanted valve exhibited confirmed thrombus formation.
  • The leaflet thrombosis was initially identified using 4D-CT imaging.

Findings:

  • Pathologic examination confirmed the presence of thrombus on the TAVR prosthesis leaflets.
  • These findings provide direct correlation between 4D-CT imaging and the actual pathologic state of leaflet thrombosis.
  • This represents the first instance of pathologic confirmation in a surviving patient.

Implications:

  • This study validates the diagnostic accuracy of 4D-CT for detecting TAVR leaflet thrombosis.
  • It reinforces the importance of 4D-CT in the clinical management of patients post-TAVR.
  • Understanding the pathologic basis of imaging findings can improve patient outcomes and treatment strategies.

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