PMID- 30528421
OWN - NLM
STAT- MEDLINE
DCOM- 20191211
LR  - 20191217
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 123
IP  - 4
DP  - 2019 Feb 15
TI  - Prospective Evaluation for Hypoattenuated Leaflet Thickening Following 
      Transcatheter Aortic Valve Implantation.
PG  - 658-666
LID - S0002-9149(18)32093-9 [pii]
LID - 10.1016/j.amjcard.2018.11.012 [doi]
AB  - Prospective investigations for the frequency of hypoattenuated leaflet thickening 
      (HALT) and its clinical implications in transcatheter aortic valve implantation 
      (TAVI) patients are limited. We initiated a prospective screening program of TAVI 
      patients for HALT beginning in July 2015. Eligible patients were evaluated with 
      gated, contrast-enhanced multidetector computed tomography within 30 days of 
      TAVI, and examined for HALT and clinical outcomes. During the study period, 287 
      patients (81 +/- 8 years; 53% men) who underwent TAVI with commercially approved 
      devices were examined. Overall, 26 patients (9.1%) had occurrence of HALT, and 
      only one of these patients had detectable hemodynamic changes on echocardiography 
      at diagnosis. Notably, 9 of 26 HALT patients had been receiving warfarin, 
      however, the HALT patients more often had subtherapeutic international normalized 
      ratio whereas using warfarin than patients without HALT on index multidetector 
      computed tomography imaging (p = 0.01). Patients who developed HALT had lower 
      baseline aortic gradient, valvuloarterial impedance, and peak aortic velocity, 
      and more commonly had been treated with balloon-expandable valves (73% of all 
      HALT cases) with a higher incidence among those who received larger prostheses. 
      All patients with HALT were placed on anticoagulation at diagnosis, and valvular 
      function remained unchanged at follow-up. Two patients with HALT (7.7%) 
      experienced ischemic stroke. A statistical trend for more major adverse clinical 
      events was present in HALT patients. In conclusion, HALT was detected in 9% of 
      TAVI cases in this prospective observational cohort, with a greater frequency in 
      patients with large, balloon-expandable prostheses. Prospective screening may be 
      considered as early HALT is reversible by timely therapeutic anticoagulation.
CI  - Copyright (c) 2018. Published by Elsevier Inc.
FAU - Tang, Liang
AU  - Tang L
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Abbott Northwestern 
      Hospital, Minneapolis, Minnesota; Department of Cardiology, The Second Xiangya 
      Hospital of Central South University, Changsha, China.
FAU - Lesser, John R
AU  - Lesser JR
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Abbott Northwestern 
      Hospital, Minneapolis, Minnesota.
FAU - Schneider, Lynelle M
AU  - Schneider LM
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Abbott Northwestern 
      Hospital, Minneapolis, Minnesota.
FAU - Burns, Marcus R
AU  - Burns MR
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Abbott Northwestern 
      Hospital, Minneapolis, Minnesota.
FAU - Gossl, Mario
AU  - Gossl M
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Abbott Northwestern 
      Hospital, Minneapolis, Minnesota.
FAU - Garberich, Ross
AU  - Garberich R
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Abbott Northwestern 
      Hospital, Minneapolis, Minnesota.
FAU - Niikura, Hiroki
AU  - Niikura H
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Abbott Northwestern 
      Hospital, Minneapolis, Minnesota.
FAU - Witt, Dawn
AU  - Witt D
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Abbott Northwestern 
      Hospital, Minneapolis, Minnesota.
FAU - Sorajja, Paul
AU  - Sorajja P
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Abbott Northwestern 
      Hospital, Minneapolis, Minnesota. Electronic address: paul.sorajja@allina.com.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20181124
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/*surgery
MH  - Female
MH  - Heart Valve Prosthesis
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Multidetector Computed Tomography
MH  - Postoperative Complications/diagnostic imaging/*epidemiology
MH  - Prospective Studies
MH  - Thrombosis/diagnostic imaging/*epidemiology
MH  - Transcatheter Aortic Valve Replacement/*adverse effects
MH  - Treatment Outcome
EDAT- 2018/12/12 06:00
MHDA- 2019/12/18 06:00
CRDT- 2018/12/12 06:00
PHST- 2018/09/13 00:00 [received]
PHST- 2018/11/05 00:00 [revised]
PHST- 2018/11/12 00:00 [accepted]
PHST- 2018/12/12 06:00 [pubmed]
PHST- 2019/12/18 06:00 [medline]
PHST- 2018/12/12 06:00 [entrez]
AID - S0002-9149(18)32093-9 [pii]
AID - 10.1016/j.amjcard.2018.11.012 [doi]
PST - ppublish
SO  - Am J Cardiol. 2019 Feb 15;123(4):658-666. doi: 10.1016/j.amjcard.2018.11.012. 
      Epub 2018 Nov 24.