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Published on: December 11, 2017
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Subclinical leaflet thrombosis following transcatheter aortic valve replacement
Somsupha Kanjanauthai1, Luigi Pirelli1, Nikhil Nalluri2
1Lenox Hill Heart and Lung, New York, New York.
Journal of Interventional Cardiology
|May 24, 2018
Summary
Transcatheter aortic valve replacement (TAVR) shows subclinical leaflet thrombosis (SLT) in up to 40% of patients. This review details SLT
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Imaging
Background:
- Transcatheter aortic valve replacement (TAVR) has advanced structural heart interventions.
- Improving transcatheter heart valve (THV) durability and reducing complications are key research areas.
- Subclinical leaflet thrombosis (SLT) is increasingly detected post-TAVR.
Purpose of the Study:
- To review the spectrum of THV leaflet thrombosis following TAVR.
- To discuss the diagnosis and current treatment strategies for SLT.
- To explore future directions in managing THV thrombosis.
Main Methods:
- Review of recent literature on THV leaflet thrombosis.
- Analysis of imaging hallmarks of SLT, including hypoattenuated leaflet thickening (HALT) and hypoattenuation affecting motion (HAM).
- Discussion of clinical implications and diagnostic criteria for SLT.
Main Results:
- Cardiac computed tomographic angiography (CTA) at 1 month post-TAVR identifies SLT in up to 40% of cases.
- Distinct imaging patterns (HALT, HAM) suggest a timeline for thrombosis progression.
- SLT may precede overt clinical symptoms.
Conclusions:
- Leaflet thrombosis is a significant, often subclinical, complication after TAVR.
- Early detection and understanding of SLT are crucial for THV durability.
- Further research is needed to optimize management and prevention strategies for THV thrombosis.
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