PMID- 32381038
OWN - NLM
STAT- MEDLINE
DCOM- 20200928
LR  - 20210919
IS  - 1749-8090 (Electronic)
IS  - 1749-8090 (Linking)
VI  - 15
IP  - 1
DP  - 2020 May 7
TI  - Hypo-attenuated leaflet thickening in surgically-implanted mitral bioprosthesis.
PG  - 74
LID - 10.1186/s13019-020-01120-3 [doi]
LID - 74
AB  - BACKGROUND: Hypo-attenuated leaflet thickening (HALT) in bioprosthetic aortic 
      valve has been studied, but its equivalent in bioprosthetic mitral valve (bMV) 
      remains uncharacterized. We sought to identify the prevalence, hemodynamic 
      characteristics, and significance of anticoagulation therapy in bMV HALT. 
      METHODS: A single-center cross-sectional study of 53 consecutive patients who 
      underwent mitral valve replacement (MVR) with bMV between 2007 and 2017 was 
      conducted. Cardiac-gated contrasted CT scans were obtained. Anticoagulant and 
      antiplatelet therapy use were ascertained at the time of hospital discharge and 
      CT scanning. Patient characteristics, postoperative stroke, and hemodynamic 
      profile by echocardiogram were obtained to descriptively characterize the 
      prevalence and characteristics associated with bMV HALT. RESULTS: Three patients 
      (5.7%) were found to have a HALT on bMV. The mean time from index MVR to CT scan 
      was 3.4 +/- 0.8 years in HALT cohort and 3.4 +/- 2.7 years in non-HALT cohort. Fifty 
      patients (94.3%) were discharged on warfarin, and 37 patients (69.8%) were on 
      warfarin at the time of CT scans. One patient with HALT was on therapeutic 
      warfarin at the time of the CT scan that identified HALT. All three patients were 
      asymptomatic at the time of CT scan. In patients with HALT, mean transmitral 
      pressure gradient were 8, 5, and 2.7 mmHg, all with trivial or mild mitral 
      regurgitation. CONCLUSIONS: In this study, the prevalence of HALT was low at 
      5.7%, all presenting without symptoms. One patient presented with HALT while on 
      therapeutic oral anticoagulation, which may suggest thrombotic etiology may not 
      adequately explain HALT.
FAU - Hosoba, Soh
AU  - Hosoba S
AD  - Division of Cardiovascular Surgery, Toyohashi Heart Center, 21 Gofuntori, 
      Oyamacho, Toyohashi, Aichi, 4418530, Japan. soh.hosoba@gmail.com.
FAU - Mori, Makoto
AU  - Mori M
AUID- ORCID: 0000-0002-2367-8354
AD  - Section of Cardiac Surgery, Yale University School of Medicine, New Haven, CT, 
      USA.
FAU - Goto, Yoshihiro
AU  - Goto Y
AD  - Division of Cardiovascular Surgery, Toyohashi Heart Center, 21 Gofuntori, 
      Oyamacho, Toyohashi, Aichi, 4418530, Japan.
FAU - Fukumoto, Yuichiro
AU  - Fukumoto Y
AD  - Division of Cardiovascular Surgery, Toyohashi Heart Center, 21 Gofuntori, 
      Oyamacho, Toyohashi, Aichi, 4418530, Japan.
FAU - Shimura, Tetsuro
AU  - Shimura T
AD  - Division of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.
FAU - Yamamoto, Masanori
AU  - Yamamoto M
AD  - Division of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.
LA  - eng
GR  - UL1 TR001863/TR/NCATS NIH HHS/United States
PT  - Journal Article
DEP - 20200507
PL  - England
TA  - J Cardiothorac Surg
JT  - Journal of cardiothoracic surgery
JID - 101265113
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 5Q7ZVV76EI (Warfarin)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/therapeutic use
MH  - *Bioprosthesis
MH  - Cross-Sectional Studies
MH  - Echocardiography
MH  - Female
MH  - Heart Valve Diseases/diagnostic imaging/*epidemiology
MH  - *Heart Valve Prosthesis
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Insufficiency/epidemiology
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Postoperative Complications/diagnostic imaging/*epidemiology
MH  - Thrombosis/diagnostic imaging/*epidemiology
MH  - Tomography, X-Ray Computed
MH  - Warfarin/therapeutic use
PMC - PMC7206689
OTO - NOTNLM
OT  - Hypo-attenuated leaflet thickening
OT  - Leaflet thrombosis
OT  - Mitral valve
COIS- None.
EDAT- 2020/05/10 06:00
MHDA- 2020/09/29 06:00
PMCR- 2020/05/07
CRDT- 2020/05/09 06:00
PHST- 2020/01/18 00:00 [received]
PHST- 2020/04/28 00:00 [accepted]
PHST- 2020/05/09 06:00 [entrez]
PHST- 2020/05/10 06:00 [pubmed]
PHST- 2020/09/29 06:00 [medline]
PHST- 2020/05/07 00:00 [pmc-release]
AID - 10.1186/s13019-020-01120-3 [pii]
AID - 1120 [pii]
AID - 10.1186/s13019-020-01120-3 [doi]
PST - epublish
SO  - J Cardiothorac Surg. 2020 May 7;15(1):74. doi: 10.1186/s13019-020-01120-3.