PMID- 26446193
OWN - NLM
STAT- MEDLINE
DCOM- 20180409
LR  - 20220408
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 37
IP  - 28
DP  - 2016 Jul 21
TI  - Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter 
      aortic heart valves.
PG  - 2263-71
LID - 10.1093/eurheartj/ehv526 [doi]
AB  - AIMS: We sought to evaluate the frequency of early hypo-attenuated leaflet 
      thickening (HALT) of the SAPIEN 3 transcatheter aortic valve (S3). METHODS AND 
      RESULTS: Of 249 patients who had undergone S3 implantation, we studied 156 
      consecutive patients (85 women, median age 82.2 +/- 5.5 years) by electrocardiogram 
      (ECG)-triggered dual-source computed tomography angiography (CTA) after a median 
      of 5 days post-transcatheter aortic valve implantation. The prosthesis was 
      assessed for HALT. Apart from heparin, peri-interventional antithrombotic therapy 
      consisted of single- (aspirin 29%) or dual- (aspirin plus clopidogrel 71%) 
      antiplatelet therapy. Hypo-attenuated leaflet thickening was found in 16 patients 
      [10.3% (95% confidence interval (CI) 5.5-15.0%)] of the patients. None of the 
      baseline and procedural variables were significantly associated with HALT, nor 
      did we find a significant association with the antithrombotic regimen, either 
      peri-interventionally or at the time of CTA. Hypo-attenuated leaflet thickening 
      was found in 6 of 45 patients with peri-interventional single-antiplatelet 
      therapy and in 10 of 111 patients with dual-antiplatelet therapy at the time of 
      intervention [13.3% (95% CI 3.4-23.3%) vs. 9% (95% CI 3.7-14.3%), P = 0.42]. 
      Hypo-attenuated leaflet thickening was not associated with clinical symptoms, but 
      a small, albeit significant difference in mean pressure gradient at the time of 
      CTA (11.6 +/- 3.4 vs. 14.9 +/- 5.3 mmHg, P = 0.026). Full anticoagulation led to 
      almost complete resolution of HALT in 13 patients with follow-up CTA. CONCLUSION: 
      Irrespective of the antiplatelet regimen, early HALT occurred in 10% of our 
      patients undergoing transcatheter aortic S3 implantation. Early HALT is 
      clinically inapparent and reversible by full anticoagulation.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2015. For permissions please email: journals.permissions@oup.com.
FAU - Pache, Gregor
AU  - Pache G
AD  - Department of Radiology, Section of Cardiovascular Radiology, University of 
      Freiburg, Sudring15, Bad Krozingen 79189, Germany 
      gregor.pache@universitaets-herzzentrum.de.
FAU - Schoechlin, Simon
AU  - Schoechlin S
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
FAU - Blanke, Philipp
AU  - Blanke P
AD  - Center for Heart Valve Innovation, St. Paul's Hospital & University of British 
      Columbia, Vancouver, Canada.
FAU - Dorfs, Stephan
AU  - Dorfs S
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
FAU - Jander, Nikolaus
AU  - Jander N
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
FAU - Arepalli, Chesnal D
AU  - Arepalli CD
AD  - Center for Heart Valve Innovation, St. Paul's Hospital & University of British 
      Columbia, Vancouver, Canada.
FAU - Gick, Michael
AU  - Gick M
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
FAU - Buettner, Heinz-Joachim
AU  - Buettner HJ
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
FAU - Leipsic, Jonathon
AU  - Leipsic J
AD  - Center for Heart Valve Innovation, St. Paul's Hospital & University of British 
      Columbia, Vancouver, Canada.
FAU - Langer, Mathias
AU  - Langer M
AD  - Department of Radiology, Section of Cardiovascular Radiology, University of 
      Freiburg, Sudring15, Bad Krozingen 79189, Germany.
FAU - Neumann, Franz-Josef
AU  - Neumann FJ
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
FAU - Ruile, Philipp
AU  - Ruile P
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
LA  - eng
PT  - Journal Article
DEP - 20151007
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
CIN - Eur Heart J. 2016 Jul 21;37(28):2272-5. PMID: 26787438
MH  - Aged, 80 and over
MH  - Aortic Valve
MH  - Female
MH  - Heart Valve Prosthesis
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Transcatheter Aortic Valve Replacement
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *Computed tomography
OT  - *Leaflet thickening
OT  - *Sapien 3
OT  - *TAVI
OT  - *Transcatheter heart valve
EDAT- 2015/10/09 06:00
MHDA- 2018/04/10 06:00
CRDT- 2015/10/09 06:00
PHST- 2015/04/16 00:00 [received]
PHST- 2015/09/18 00:00 [accepted]
PHST- 2015/10/09 06:00 [entrez]
PHST- 2015/10/09 06:00 [pubmed]
PHST- 2018/04/10 06:00 [medline]
AID - ehv526 [pii]
AID - 10.1093/eurheartj/ehv526 [doi]
PST - ppublish
SO  - Eur Heart J. 2016 Jul 21;37(28):2263-71. doi: 10.1093/eurheartj/ehv526. Epub 2015 
      Oct 7.