2024 Volume 54 Issue 3 Pages 125-134
Background: Subclinical leaflet thrombosis (SLT) has been reported after transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis (AS). The details of the evaluation methods used are unclear, however.
Objectives: This study evaluated post-TAVR SLT using multidetector row computed tomography (MDCT) and transthoracic echocardiography (TTE).
Methods: The TAVR was performed in patients with severe AS at our hospital between September 2016 and October 2019. The 80 patients who were eligible for MDCT and TTE during early-period post-TAVR were evaluated for SLT.
Results: Among the 80 patients eligible, MDCT performed during early post-TAVR revealed hypo-attenuated leaflet thickening (HALT) in 19 (24％), which was also observed with moderately or severely reduced leaflet motion (RELM) in 9 (11％). With TTE, however, prosthetic leaflet thrombosis could be detected in only 2 patients. The TTE findings in the HALT (＋) group were peak flow velocity, 2.25 ± 0.47 m/sec; mean pressure gradient, 10.9 ± 4.4 mmHg; effective orifice area (EOA), 1.47 ± 0.47 cm2; and an EOA index score of 1.01 ± 0.30 cm2/m2. These findings were not significantly different between the HALT (＋) and HALT (−) groups.
Conclusion: In the early post-TAVR period, 24％ of patients had HALT and 11％ had HALT with moderate or severe RELM on MDCT, indicating that additional MDCT in addition to TTE in the early post-TAVR period is more likely to detect SLT.
