PMID- 36444836
OWN - NLM
STAT- MEDLINE
DCOM- 20221215
LR  - 20230302
IS  - 2047-9980 (Electronic)
IS  - 2047-9980 (Linking)
VI  - 11
IP  - 23
DP  - 2022 Dec 6
TI  - Natural History of Leaflet Thrombosis After Transcatheter Aortic Valve 
      Replacement: A 5-Year Follow-Up Study.
PG  - e026334
LID - 10.1161/JAHA.122.026334 [doi]
LID - e026334
AB  - Background Subclinical leaflet thrombosis, characterized by hypoattenuated 
      leaflet thickening (HALT) on multidetector computed tomography, is common after 
      transcatheter aortic valve replacement (TAVR). Because little is known about the 
      long-term natural history of subclinical HALT, we aimed to investigate this in 
      patients who underwent TAVR without using additional anticoagulation. Methods and 
      Results We retrospectively evaluated patients who underwent TAVR with the Edwards 
      SAPIEN-XT at our institute between October 2013 and December 2015. Patients were 
      grouped according to the presence or absence of HALT within 1 year after TAVR 
      (HALT and No-HALT groups). The primary outcome, defined as the composite of 
      all-cause mortality, heart failure readmission, and ischemic stroke, was 
      compared. Valve performance was assessed over time by transthoracic 
      echocardiography. Among 124 patients (men: 29.1%; median age, 85 years), 27 
      (21.8%) showed HALT on multidetector computed tomography within 1 year after 
      TAVR. No patient required additional anticoagulation for treating HALT because of 
      the absence of valve-related symptomatic deterioration. During the median 
      follow-up period of 4.7 years (interquartile range, 4.0-5.6), the rate of primary 
      outcome and valve performance was not statistically different between the 2 
      groups (37.0% versus 38.1%; log-rank test P=0.92; mean pressure gradient, 9 mm Hg 
      [8-14 mm Hg] versus 10 mm Hg [7-15 mm Hg]; P=0.51, respectively). Conclusions 
      Approximately 20% of patients after TAVR had HALT within 1 year; however, that 
      did not change the risk of subsequent adverse cardiovascular events or the valve 
      performance with statistical significance for up to 5 years despite no additional 
      anticoagulation therapy.
FAU - Imaeda, Shohei
AU  - Imaeda S
AUID- ORCID: 0000-0002-6211-1617
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Inohara, Taku
AU  - Inohara T
AUID- ORCID: 0000-0002-7889-2083
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Yoshijima, Nobuhiro
AU  - Yoshijima N
AD  - Department of Cardiology Saiseikai Utsunomiya Hospital Tochigi Japan.
FAU - Kobari, Yusuke
AU  - Kobari Y
AUID- ORCID: 0000-0002-6144-9747
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Myojin, Sosuke
AU  - Myojin S
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Ryuzaki, Toshinobu
AU  - Ryuzaki T
AUID- ORCID: 0000-0002-6450-860X
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Hattori, Osamu
AU  - Hattori O
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Shinada, Keitaro
AU  - Shinada K
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Tsuruta, Hikaru
AU  - Tsuruta H
AUID- ORCID: 0000-0002-3002-966X
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Takahashi, Tatsuo
AU  - Takahashi T
AUID- ORCID: 0000-0002-3700-2195
AD  - Department of Cardiovascular Surgery Keio University School of Medicine Tokyo 
      Japan.
FAU - Yamazaki, Masataka
AU  - Yamazaki M
AUID- ORCID: 0000-0002-5442-4146
AD  - Department of Cardiovascular Surgery Keio University School of Medicine Tokyo 
      Japan.
FAU - Kato, Jungo
AU  - Kato J
AUID- ORCID: 0000-0003-0918-4240
AD  - Department of Anesthesiology Keio University School of Medicine Tokyo Japan.
FAU - Yamada, Yoshitake
AU  - Yamada Y
AUID- ORCID: 0000-0002-5842-5349
AD  - Department of Radiology Keio University School of Medicine Tokyo Japan.
FAU - Jinzaki, Masahiro
AU  - Jinzaki M
AUID- ORCID: 0000-0002-8241-6565
AD  - Department of Radiology Keio University School of Medicine Tokyo Japan.
FAU - Shimizu, Hideyuki
AU  - Shimizu H
AUID- ORCID: 0000-0003-0298-4261
AD  - Department of Cardiovascular Surgery Keio University School of Medicine Tokyo 
      Japan.
FAU - Fukuda, Keiichi
AU  - Fukuda K
AUID- ORCID: 0000-0003-1413-0482
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
FAU - Hayashida, Kentaro
AU  - Hayashida K
AUID- ORCID: 0000-0002-1750-1982
AD  - Department of Cardiology Keio University School of Medicine Tokyo Japan.
LA  - eng
PT  - Journal Article
DEP - 20221129
PL  - England
TA  - J Am Heart Assoc
JT  - Journal of the American Heart Association
JID - 101580524
SB  - IM
CIN - J Am Heart Assoc. 2022 Dec 6;11(23):e028275. PMID: 36444849
MH  - Humans
MH  - Aged, 80 and over
MH  - *Transcatheter Aortic Valve Replacement/adverse effects
MH  - Follow-Up Studies
MH  - Retrospective Studies
PMC - PMC9851443
OTO - NOTNLM
OT  - aortic valve stenosis
OT  - hypoattenuated leaflet thickening
OT  - transcatheter aortic valve replacement
EDAT- 2022/11/30 06:00
MHDA- 2022/12/15 06:00
PMCR- 2022/12/01
CRDT- 2022/11/29 06:13
PHST- 2022/11/30 06:00 [pubmed]
PHST- 2022/12/15 06:00 [medline]
PHST- 2022/11/29 06:13 [entrez]
PHST- 2022/12/01 00:00 [pmc-release]
AID - JAH37917 [pii]
AID - 10.1161/JAHA.122.026334 [doi]
PST - ppublish
SO  - J Am Heart Assoc. 2022 Dec 6;11(23):e026334. doi: 10.1161/JAHA.122.026334. Epub 
      2022 Nov 29.