Subclinical Leaflet Thrombosis and Clinical Outcomes after TAVR: A Systematic Review and Meta-Analysis

Kalra, Ankur; Raza, Sajjad; Puri, Rishi; Deo, Salil V.; Auffret, Vincent; Khera, Sahil; Attizzani, Guilherme F.; Zia, Aisha; Khan, Mohammad S; Reardon, Michael J.; Kleiman, Neal S.; Latib, Azeem; Rodés‐Cabau, Josep; Sabik, Joseph F.; Bhatt, Deepak L.

doi:10.1080/24748706.2018.1440678

Cited by 8 publications

(3 citation statements)

References 20 publications

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“…Registry data from 2,555 patients revealed a 5.5% valve degeneration rate at 12 months, and anticoagulation was protective against valve degeneration (13). Whilst some studies have reported an association between subclinical leaflet thrombosis and transient ischaemic attack and stroke (5), others did not (14,15).…”

Section: Bioprosthetic Valve Thrombosismentioning

confidence: 99%

Bioprosthetic valve thrombosis and degeneration following transcatheter aortic valve implantation (TAVI)

et al. 2021

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Section: Bioprosthetic Valve Thrombosismentioning

confidence: 99%

Bioprosthetic valve thrombosis and degeneration following transcatheter aortic valve implantation (TAVI)

et al. 2021

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“…Evidently, questions were raised as to how these subclinical imaging findings translate to a need for further optimization of medical anticoagulant therapy, and regarding their impact on prognosis and incidence of thrombo-embolic events like stroke. A meta-analysis in 2018 indicated that, while there is an overall incidence of HALT with or without RLM of about 15 %, there was no significant association with the presence of stroke, transient ischemic attack (TIA), or the combined stroke/TIA endpoint [86]. However, a more recent meta-analysis did find an increased stroke risk [87].…”

Section: Subclinical Leaflet Thrombosismentioning

confidence: 99%

Transcatheter Aortic Valve Implantation: The Evolving Role of the Radiologist in 2021

Salgado¹,

Addouli²,

Budde

2021

Rofo

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Background Transcatheter aortic valve implantation (TAVI) has gained worldwide acceptance and implementation as an alternative therapeutic option in patients with severe aortic valve stenosis unable to safely undergo surgical aortic valve replacement. This transformative technique places the radiologist in a key position in the pre-procedural assessment of potential candidates for this technique, delivering key anatomical information necessary for patient eligibility and procedural safety. Recent trials also provide encouraging results to potentially extend the indication to patients with safer risk profiles. Method The review is based on a PubMed literature search using the search terms “transcatheter heart valve”, “TAVI”, “TAVR”, “CT”, “imaging”, “MR” over a period from 2010–2020, combined with personal comments based on the author’s experience. Results and Conclusion CT plays a prominent role in the pre-procedural workup, delivering as a true 3D imaging modality optimal visualization of the complex anatomy of the aortic root with simultaneous evaluation of the patency of the different access routes. As such, the contribution of CT is key for the determination of patient eligibility and procedural safety. This input is supplementary to the contributions of other imaging modalities and forms an important element in the discussions of the Heart Valve Team. Knowledge of the procedure and its characteristics is necessary in order to provide a comprehensive and complete report. While the role of CT in the pre-procedural evaluation is well established, the contribution of CT and MR and the clinical significance of their findings in the routine follow-up after the intervention are less clear and currently the subject of intense investigation. Important issues remain, including the occurrence and significance of subclinical leaflet thrombosis, prosthetic heart valve endocarditis, and long-term structural valve degeneration. Key Points: Citation Format

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“…Additionally, bioprosthetic valve thrombosis, in either the subclinical or more overt form, which was previously felt to be an issue only with mechanical valves, is now an increasingly appreciated issue with potentially significant complications. [6][7][8][9][10] Thus, despite the enormous strides made with prosthetic heart valves to date, considerable work remains with regard to producing a more durable, thrombus-resistant valve that would ideally be deliverable from a catheterbased approach.…”

mentioning

confidence: 99%

Polymeric Heart Valves: Back to the Future?

Resor

Bhatt

2019

Matter

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Subclinical Leaflet Thrombosis and Clinical Outcomes after TAVR: A Systematic Review and Meta-Analysis

Cited by 8 publications

References 20 publications

Bioprosthetic valve thrombosis and degeneration following transcatheter aortic valve implantation (TAVI)

Bioprosthetic valve thrombosis and degeneration following transcatheter aortic valve implantation (TAVI)

Transcatheter Aortic Valve Implantation: The Evolving Role of the Radiologist in 2021

Polymeric Heart Valves: Back to the Future?

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