PMID- 33129688
OWN - NLM
STAT- MEDLINE
DCOM- 20211022
LR  - 20220531
IS  - 1878-0938 (Electronic)
IS  - 1878-0938 (Linking)
VI  - 27
DP  - 2021 Jun
TI  - Anatomical Characteristics Associated With Hypoattenuated Leaflet Thickening in 
      Low-Risk Patients Undergoing Transcatheter Aortic Valve Replacement.
PG  - 1-6
LID - S1553-8389(20)30586-8 [pii]
LID - 10.1016/j.carrev.2020.09.034 [doi]
AB  - BACKGROUND/PURPOSE: This sub-analysis of the prospective Low Risk TAVR (LRT) 
      trial determined anatomical characteristics associated with hypoattenuated 
      leaflet thickening (HALT), which may contribute to early transcatheter heart 
      valve (THV) degeneration. METHODS/MATERIALS: The LRT trial enrolled 200 low-risk 
      patients between February 2016 and February 2018. All subjects underwent baseline 
      and 30-day CT studies, analyzed by an independent core laboratory. Additional 
      measurements, namely THV expansion, eccentricity, depth, and commissural 
      alignment, were made by consensus of three independent readers. HALT was observed 
      only in the Sapien 3 THV, so Evolut valves were excluded from this analysis. 
      RESULTS: In the LRT trial, 177 subjects received Sapien 3 THVs, of whom 167 
      (94.3%) had interpretable 30-day CTs and were eligible for this analysis. 
      Twenty-six subjects had HALT (15.6%). Baseline characteristics were similar 
      between groups. There was no difference in THV size implanted and baseline 
      aortic-root geometry between groups. In patients who developed HALT, THV 
      implantation depth was shallower than in patients who did not develop HALT 
      (2.6 +/- 1.1 mm HALT versus 3.3 +/- 1.8 mm no-HALT, p = 0.03). There were more 
      patients in the HALT group with commissural malalignment (40% vs. 28%; p = 0.25), 
      but this did not reach statistical significance. In a univariable regression 
      model, no predetermined variables were shown to independently predict the 
      development of HALT. CONCLUSIONS: This study did not find anatomical or THV 
      implantation characteristics that predicted the development of HALT at 30 days. 
      This study cannot exclude subtle effects or interaction between factors because 
      of the small number of events.
CI  - Copyright (c) 2020. Published by Elsevier Inc.
FAU - Khan, Jaffar M
AU  - Khan JM
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America; Cardiovascular Branch, Division of 
      Intramural Research, National Heart Lung and Blood Institute, National Institutes 
      of Health, Bethesda, MD, United States of America.
FAU - Rogers, Toby
AU  - Rogers T
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America; Cardiovascular Branch, Division of 
      Intramural Research, National Heart Lung and Blood Institute, National Institutes 
      of Health, Bethesda, MD, United States of America.
FAU - Weissman, Gaby
AU  - Weissman G
AD  - Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, 
      United States of America.
FAU - Torguson, Rebecca
AU  - Torguson R
AD  - Department of Cardiovascular Research and Clinical Trials, Icahn School of 
      Medicine at Mount Sinai, New York, NY, United States of America.
FAU - Rodriguez-Weisson, Fernando J
AU  - Rodriguez-Weisson FJ
AD  - MedStar Health Research Institute, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Chezar-Azerrad, Chava
AU  - Chezar-Azerrad C
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Greenspun, Benjamin
AU  - Greenspun B
AD  - Georgetown University, Washington, DC, United States of America.
FAU - Gupta, Neha
AU  - Gupta N
AD  - Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, 
      United States of America.
FAU - Medvedofsky, Diego
AU  - Medvedofsky D
AD  - MedStar Health Research Institute, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Zhang, Cheng
AU  - Zhang C
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Gordon, Paul
AU  - Gordon P
AD  - Division of Cardiology, The Miriam Hospital, Providence, RI, United States of 
      America.
FAU - Ehsan, Afshin
AU  - Ehsan A
AD  - Division of Cardiothoracic Surgery, Lifespan Cardiovascular Institute, 
      Providence, RI, United States of America.
FAU - Wilson, Sean R
AU  - Wilson SR
AD  - Department of Medicine, The Valley Hospital, Ridgewood, NJ, United States of 
      America.
FAU - Goncalves, John
AU  - Goncalves J
AD  - Cardiac Surgery Program, The Valley Hospital, Ridgewood, NJ, United States of 
      America.
FAU - Levitt, Robert
AU  - Levitt R
AD  - Department of Cardiology, Henrico Doctors' Hospital, Richmond, VA, United States 
      of America.
FAU - Hahn, Chiwon
AU  - Hahn C
AD  - Department of Cardiothoracic Surgery, Henrico Doctors' Hospital, Richmond, VA, 
      United States of America.
FAU - Parikh, Puja
AU  - Parikh P
AD  - Department of Medicine, Stony Brook Hospital, Stony Brook, NY, United States of 
      America.
FAU - Bilfinger, Thomas
AU  - Bilfinger T
AD  - Department of Surgery, Stony Brook Hospital, Stony Brook, NY, United States of 
      America.
FAU - Butzel, David
AU  - Butzel D
AD  - Cardiovascular Service Line, Maine Medical Center, Portland, ME, United States of 
      America.
FAU - Buchanan, Scott
AU  - Buchanan S
AD  - Cardiovascular Service Line, Maine Medical Center, Portland, ME, United States of 
      America.
FAU - Hanna, Nicholas
AU  - Hanna N
AD  - St. John Heart Institute Cardiovascular Consultants, St. John Health System, 
      Tulsa, OK, United States of America.
FAU - Garrett, Robert
AU  - Garrett R
AD  - St. John Clinic Cardiovascular Surgery, St. John Heart Institute Cardiovascular 
      Consultants, St. John Health System, Tulsa, OK, United States of America.
FAU - Shults, Christian
AU  - Shults C
AD  - Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington, 
      DC, United States of America.
FAU - Buchbinder, Maurice
AU  - Buchbinder M
AD  - Foundation for Cardiovascular Medicine, Stanford University, Stanford, CA, United 
      States of America.
FAU - Garcia-Garcia, Hector M
AU  - Garcia-Garcia HM
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Kolm, Paul
AU  - Kolm P
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Satler, Lowell F
AU  - Satler LF
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Hashim, Hayder
AU  - Hashim H
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Ben-Dor, Itsik
AU  - Ben-Dor I
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Asch, Federico M
AU  - Asch FM
AD  - MedStar Health Research Institute, MedStar Washington Hospital Center, 
      Washington, DC, United States of America.
FAU - Waksman, Ron
AU  - Waksman R
AD  - Section of Interventional Cardiology, MedStar Washington Hospital Center, 
      Washington, DC, United States of America. Electronic address: 
      ron.waksman@medstar.net.
LA  - eng
SI  - ClinicalTrials.gov/NCT02628899
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200925
PL  - United States
TA  - Cardiovasc Revasc Med
JT  - Cardiovascular revascularization medicine : including molecular interventions
JID - 101238551
SB  - IM
MH  - Aortic Valve/diagnostic imaging/surgery
MH  - *Aortic Valve Stenosis/diagnostic imaging/surgery
MH  - *Heart Valve Prosthesis
MH  - Humans
MH  - Prospective Studies
MH  - Prosthesis Design
MH  - *Transcatheter Aortic Valve Replacement/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Hypoattenuated leaflet thickening
OT  - Low risk
OT  - Structural valve degeneration
OT  - Transcatheter aortic valve replacement
COIS- Declaration of competing interest All other authors have no conflicts of interest 
      to disclose.
EDAT- 2020/11/02 06:00
MHDA- 2021/10/26 06:00
CRDT- 2020/11/01 20:28
PHST- 2020/09/22 00:00 [received]
PHST- 2020/09/22 00:00 [accepted]
PHST- 2020/11/02 06:00 [pubmed]
PHST- 2021/10/26 06:00 [medline]
PHST- 2020/11/01 20:28 [entrez]
AID - S1553-8389(20)30586-8 [pii]
AID - 10.1016/j.carrev.2020.09.034 [doi]
PST - ppublish
SO  - Cardiovasc Revasc Med. 2021 Jun;27:1-6. doi: 10.1016/j.carrev.2020.09.034. Epub 
      2020 Sep 25.