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Hypoattenuated Leaflet Thickening: A Comprehensive Review of Contemporary Data

Nika Samadzadeh Tabrizi1, Gregory Fishberger2, Sridhar R Musuku1

  • 1Department of Anesthesiology, Albany Medical Center, Albany, NY.

Journal of Cardiothoracic and Vascular Anesthesia
|July 23, 2024
PubMed

Insights

Hypoattenuated leaflet thickening (HALT) affects nearly one-third of patients after aortic valve replacement. This review examines HALT risk factors, prevention, and treatment for better patient outcomes.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Radiology

Background:

  • Hypoattenuated leaflet thickening (HALT) is common after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR).
  • HALT often indicates subclinical leaflet thrombosis but can progress to valve dysfunction.
  • There is no current consensus on HALT screening or management.

Purpose of the Study:

  • To comprehensively review the evidence on risk factors, prevention, treatment, and prognosis of HALT.
  • To address the clinical significance and management of HALT in patients post-SAVR and TAVR.

Main Methods:

  • Systematic review of existing literature on HALT.
  • Evaluation of studies reporting on risk factors, clinical presentation, and outcomes of HALT.
  • Analysis of current screening and management strategies.

Main Results:

  • HALT affects approximately one-third of patients within one year of SAVR or TAVR.
  • HALT is often incidentally detected in asymptomatic patients.
  • Progression of HALT can lead to leaflet immobility and valve deterioration.

Conclusions:

  • Further research is needed to clarify the clinical significance of HALT.
  • Establishing standardized screening and management protocols for HALT is crucial.
  • Understanding HALT is essential for optimizing long-term outcomes after aortic valve replacement.

Keywords:
aortic valve replacementhypo-attenuated leaflet thickeningleaflet thrombosistranscatheter aortic valve replacement

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