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Journal articles on the topic 'Leaflet thrombosis'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Khodaee, Farhan, Mohammed Barakat, Mostafa Abbasi, Danny Dvir, and Ali N. Azadani. "Incomplete expansion of transcatheter aortic valves is associated with propensity for valve thrombosis." Interactive CardioVascular and Thoracic Surgery 30, no. 1 (September 5, 2019): 39–46. http://dx.doi.org/10.1093/icvts/ivz213.

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Abstract OBJECTIVES Clinical and subclinical leaflet thromboses are increasingly recognized complications following transcatheter aortic valve replacement. Identification of the risk factors is important to mitigate the occurrence of leaflet thrombosis in transcatheter aortic valves (TAVs) and ensure their long-term function. The goal of this study was to determine the effect of incomplete expansion of TAVs on the likelihood of leaflet thrombosis following transcatheter aortic valve replacement. METHODS Using experimental and computational methods, 3-dimensional unsteady flow fields of 26-mm SAPIEN 3 valves expanded to 3 different diameters (i.e. 26.0 mm, 23.4 mm and 20.8 mm) were determined in patient-specific geometries. The diameters corresponded to 100%, 90% and 80% stent expansion, respectively. To address the potential difference in the likelihood of leaflet thrombosis, blood residence time (i.e. stasis) and viscous shear stress on the surface of TAV leaflets were quantified and compared. RESULTS The results indicated that TAV underexpansion increased blood stasis on the TAV leaflets. Blood residence time on the surface of the leaflets after 80% and 90% TAV expansion on average was 9.4% and 4.1% more than that of the fully expanded TAV, respectively. In addition, areas of blood stasis time of more than 0.5 s, which are highly prone to platelet activation, increased linearly as the degree of TAV underexpansion increased. CONCLUSIONS Incomplete expansion of TAVs increases blood stasis on the surface of TAV leaflets. Regions of blood stasis promote platelet activation and thrombotic events. TAV underexpansion can therefore increase the risk of leaflet thrombosis in patients with transcatheter aortic valve replacement.

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2

Piayda, Kerstin, Tobias Zeus, Horst Sievert, Malte Kelm, and Amin Polzin. "Subclinical leaflet thrombosis." Lancet 391, no. 10124 (March 2018): 937–38. http://dx.doi.org/10.1016/s0140-6736(18)30534-8.

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3

Makkar, Raj, and Tarun Chakravarty. "Early Leaflet Thrombosis." JACC: Cardiovascular Interventions 11, no. 12 (June 2018): 1172–74. http://dx.doi.org/10.1016/j.jcin.2018.05.030.

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4

Sondergaard, Lars, Cesna Sigitas, Manik Chopra, Gintautas Bieliauskas, and Ole De Backer. "Leaflet Thrombosis after TAVI." European Heart Journal 38, no. 36 (September 21, 2017): 2702–3. http://dx.doi.org/10.1093/eurheartj/ehx473.

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5

Carabello, Blase A. "Bioprosthetic Valve Leaflet Thrombosis." Journal of the American College of Cardiology 75, no. 8 (March 2020): 867–69. http://dx.doi.org/10.1016/j.jacc.2019.12.038.

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6

Lieben, Liesbet. "Leaflet thrombosis after AVR." Nature Reviews Cardiology 14, no. 5 (May 2017): 256. http://dx.doi.org/10.1038/nrcardio.2017.54.

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7

Plitman Mayo, Romina, Halit Yaakobovich, Ariel Finkelstein, Shawn C. Shadden, and Gil Marom. "Numerical models for assessing the risk of leaflet thrombosis post-transcatheter aortic valve-in-valve implantation." Royal Society Open Science 7, no. 12 (December 2020): 201838. http://dx.doi.org/10.1098/rsos.201838.

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Leaflet thrombosis has been suggested as the reason for the reduced leaflet motion in cases of hypoattenuated leaflet thickening of bioprosthetic aortic valves. This work aimed to estimate the risk of leaflet thrombosis in two post-valve-in-valve (ViV) configurations, using five different numerical approaches. Realistic ViV configurations were calculated by modelling the deployments of the latest version of transcatheter aortic valve devices (Medtronic Evolut PRO, Edwards SAPIEN 3) in the surgical Sorin Mitroflow. Computational fluid dynamics simulations of blood flow followed the dry models. Lagrangian and Eulerian measures of near-wall stagnation were implemented by particle and concentration tracking, respectively, to estimate the thrombogenicity and to predict the risk locations. Most of the numerical approaches indicate a higher leaflet thrombosis risk in the Edwards SAPIEN 3 device because of its intra-annular implantation. The Eulerian approaches estimated high-risk locations in agreement with the wall sheer stress (WSS) separation points. On the other hand, the Lagrangian approaches predicted high-risk locations at the proximal regions of the leaflets matching the low WSS magnitude regions of both transcatheter aortic valve implantation models and reported clinical and experimental data. The proposed methods can help optimizing future designs of transcatheter aortic valves with minimal thrombotic risks.

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8

Marcelli, Emanuela, Barbara Bortolani, Ivan Corazza, and Laura Cercenelli. "A Novel Sensorized Heart Valve Prosthesis: Preliminary In Vitro Evaluation." Sensors 18, no. 11 (November 13, 2018): 3905. http://dx.doi.org/10.3390/s18113905.

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Background: Recent studies have shown that subclinical valve thrombosis in heart valve prosthesis (HVP) can be responsible for reduced leaflet motion detectable only by advanced imaging diagnostics. We conceived a novel sensorized HVP able to detect earlier any thrombus formation that may alter the leaflets motion using an electric impedance measurement, IntraValvular Impedance (IVI). Methods: For IVI measurement, dedicated electrodes are embedded in the structure of the HVP to generate a local electric field that is altered by the moving valve leaflets during their cyclic opening/closing. We present preliminary in vitro results using a first prototype of sensorized mechanical heart valve connected to an external impedance measurement system. The prototype was tested on a circulatory mock loop system and the IVI signals were recorded during both normal dynamics and experimentally induced altered working of the leaflets. Results: Recordings showed a very repetitive and stable IVI signal during the normal cyclic opening/closing of the HVP. The induced alterations in leaflet motion were reflected in the IVI signal. Conclusions: The novel sensorized HVP has great potential to give early warning of possible subclinical valve thrombosis altering the valve leaflet motion, and to help in tailoring the anticoagulation therapy.

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9

Phifer, Travis J., and Michael S. Rohr. "The Pathogenesis of Leaflet Failure in Prosthetic Venous Valves." Phlebology: The Journal of Venous Disease 3, no. 2 (June 1988): 115–21. http://dx.doi.org/10.1177/026835558800300208.

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Recent work from this laboratory established feasibility for long-term patency of properly designed valvular xenografts placed without technical fault in the inferior vena cava. Limitations of that work however, included perileaflet fibrosis with reduction of leaflet mobility. The current study evaluates perileaflet thrombosis potentiated by the nonendothelialized leaflet surface as the primary pathogenic mechanism of this problem. The study includes 18 pericardial xenograft valvular bioprostheses and nine jugular vein valvular autografts placed in the inferior vena cava of 27 dogs All animals received a single bolus of heparin (100u/kg) 5min before vascular clamping. The valves were removed and examined from 1 day to 7.5 months after placement. In valvular xenografts, perileaflet thrombosis by 1 day progressed to dense fibrosis at 2 months. Despite limitation of leaflet motion, this process caused luminal occlusion in only three valves (83% patency). There were no failures in the nine valvular autografts, with normal valve leaflets and no evidence of thrombus formation as late as 6 months. Perileaflet thrombosis in pericardial xenograft bioprostheses is a primary event in the ultimate fibrosis of these prosthetic venous valves. Inhibition of thrombosis by the venous endothelial lining may be an explanation for success with the smaller valvular autografts in the same haemodynamic environment.

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10

Ng, Arnold C. T., David R. Holmes, Michael J. Mack, Victoria Delgado, Raj Makkar, Philipp Blanke, Jonathon A. Leipsic, Martin B. Leon, and Jeroen J. Bax. "Leaflet immobility and thrombosis in transcatheter aortic valve replacement." European Heart Journal 41, no. 33 (September 1, 2020): 3184–97. http://dx.doi.org/10.1093/eurheartj/ehaa542.

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Abstract Transcatheter aortic valve replacement (TAVR) has grown exponentially worldwide in the last decade. Due to the higher bleeding risks associated with oral anticoagulation and in patients undergoing TAVR, antiplatelet therapy is currently considered first-line antithrombotic treatment after TAVR. Recent studies suggest that some patients can develop subclinical transcatheter heart valve (THV) thrombosis after the procedure, whereby thrombus forms on the leaflets that can be a precursor to leaflet dysfunction. Compared with echocardiography, multidetector computed tomography is more sensitive at detecting THV thrombosis. Transcatheter heart valve thrombosis can occur while on dual antiplatelet therapy with aspirin and thienopyridine but significantly less with anticoagulation. This review summarizes the incidence and diagnostic criteria for THV thrombosis and discusses the pathophysiological mechanisms that may lead to thrombus formation, its natural history, potential clinical implications and treatment for these patients.

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11

Khav, Nancy, Hashrul N. Rashid, and Adam J. Brown. "The role of four-dimensional computed tomography in transcatheter aortic valve replacement prosthesis endocarditis with concurrent leaflet thrombosis: a case report." European Heart Journal - Case Reports 4, no. 5 (September 4, 2020): 1–5. http://dx.doi.org/10.1093/ehjcr/ytaa252.

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Abstract Background Transcatheter aortic valve replacement (TAVR) is becoming increasingly utilized for the treatment of severe aortic valvular heart disease. Infective endocarditis of TAVR is rare but associated with higher mortality and morbidity. The potential for leaflet thrombosis following TAVR is also becoming increasingly recognized. Diagnosis of these conditions on echocardiography can be challenging due to prosthesis artefact. Case summary An 84-year-old man with a previous transcatheter aortic valve replacement presented with a febrile illness and bacteraemia. Transthoracic and transoesophageal echocardiography demonstrated high transvalvular gradients with features of prosthesis endocarditis, though leaflet morphology could not be fully assessed due to prosthesis artefact. Four-dimensional computed tomography revealed hypo-attenuated leaflet thickening with reduced leaflet motion, consistent with prosthesis leaflet thrombosis. The patient was successfully treated with antibiotics and anticoagulation, with resolution of the infection and normalization of the transvalvular gradient after 6 weeks. Discussion Echocardiography should be the first-line investigation for assessing leaflet morphology in suspected prosthetic valve endocarditis or leaflet thrombosis but its accuracy may be limited by artefact. Our case highlights that four-dimensional computed tomography provides further evaluation of prosthesis leaflet morphology/motion, providing valuable diagnostic information.

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12

Holmes, David R., and Michael J. Mack. "Uncertainty and Possible Subclinical Valve Leaflet Thrombosis." New England Journal of Medicine 373, no. 21 (November 19, 2015): 2080–82. http://dx.doi.org/10.1056/nejme1511683.

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13

Marwan, M., N. Mekkhala, M. Göller, J. Röther, D. Bittner, A. Schuhbaeck, M. Hell, et al. "Leaflet thrombosis following transcatheter aortic valve implantation." Journal of Cardiovascular Computed Tomography 12, no. 1 (January 2018): 8–13. http://dx.doi.org/10.1016/j.jcct.2017.11.002.

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14

Sondergaard, Lars. "Subclinical Leaflet Thrombosis in Bioprosthetic Aortic Valves." JACC: Cardiovascular Interventions 10, no. 2 (January 2017): 204–5. http://dx.doi.org/10.1016/j.jcin.2016.10.042.

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15

Testa, Luca, and Azeem Latib. "Assessing the Risk of Leaflet Motion Abnormality Following Transcatheter Aortic Valve Implantation." Interventional Cardiology Review 13, no. 1 (2017): 1. http://dx.doi.org/10.15420/icr.2017:24:2.

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Leaflet motion abnormalities are a relatively new entity in the field of transcatheter aortic valve implantation and are associated with a range of different conditions, the extreme being prosthetic valve dysfunction with high gradients or central regurgitation and possibly early thrombotic degeneration. Another extreme condition is the incidental finding of leaflet thickening, but with normal transvalvular gradients. Transthoracic echocardiography is a useful screening tool for the detection of symptomatic thrombosis, but it has limited use in the detection of subclinical thrombosis and/or motion abnormalities alone. We, hereby, discuss the evidence for the potential screening process and subsequent management of those conditions associated with the leaflet motion abnormalities.

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16

Vahidkhah, Koohyar, Shahnaz Javani, Mostafa Abbasi, Peyman N. Azadani, Anwar Tandar, Danny Dvir, and Ali N. Azadani. "Blood Stasis on Transcatheter Valve Leaflets and Implications for Valve-in-Valve Leaflet Thrombosis." Annals of Thoracic Surgery 104, no. 3 (September 2017): 751–59. http://dx.doi.org/10.1016/j.athoracsur.2017.02.052.

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17

Kim, Won-Keun, and Efstratios Charitos. "Prosthesis Type–Associated Risk of Subclinical Leaflet Thrombosis." JACC: Cardiovascular Interventions 15, no. 6 (March 2022): 676. http://dx.doi.org/10.1016/j.jcin.2022.01.296.

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18

Bogyi, Matthias, Rüdiger E. Schernthaner, Christian Loewe, Gloria M. Gager, Al Medina Dizdarevic, Christina Kronberger, Marek Postula, et al. "Subclinical Leaflet Thrombosis After Transcatheter Aortic Valve Replacement." JACC: Cardiovascular Interventions 14, no. 24 (December 2021): 2643–56. http://dx.doi.org/10.1016/j.jcin.2021.09.019.

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19

Kanjanauthai, Somsupha, Luigi Pirelli, Nikhil Nalluri, and Chad A. Kliger. "Subclinical leaflet thrombosis following transcatheter aortic valve replacement." Journal of Interventional Cardiology 31, no. 5 (May 23, 2018): 640–47. http://dx.doi.org/10.1111/joic.12521.

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20

Makkar, Raj R., Gregory Fontana, Hasan Jilaihawi, Tarun Chakravarty, Klaus F. Kofoed, Ole De Backer, Federico M. Asch, et al. "Possible Subclinical Leaflet Thrombosis in Bioprosthetic Aortic Valves." New England Journal of Medicine 373, no. 21 (November 19, 2015): 2015–24. http://dx.doi.org/10.1056/nejmoa1509233.

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21

Imran, U. H., A. Soo, C. Wilson, and A. Graham. "Heart failure due to prosthetic mitral leaflet thrombosis." Case Reports 2011, apr15 2 (April 18, 2011): bcr0320113969. http://dx.doi.org/10.1136/bcr.03.2011.3969.

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22

Marwan, M. "Reply: Leaflet thrombosis following transcatheter aortic valve implantation." Journal of Cardiovascular Computed Tomography 12, no. 3 (May 2018): e3. http://dx.doi.org/10.1016/j.jcct.2018.03.002.

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23

Rashid, Hashrul N., James D. Cameron, and Arthur Nasis. "Correspondence: Leaflet thrombosis following transcatheter aortic valve implantation." Journal of Cardiovascular Computed Tomography 12, no. 3 (May 2018): e4. http://dx.doi.org/10.1016/j.jcct.2018.03.003.

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24

Aktuerk, Dincer, Saeed Mirsadraee, Cesare Quarto, Simon Davies, and Alison Duncan. "Leaflet thrombosis after valve-in-valve transcatheter aortic valve implantation: a case series." European Heart Journal - Case Reports 4, no. 4 (August 1, 2020): 1–6. http://dx.doi.org/10.1093/ehjcr/ytaa221.

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Abstract Background Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) in degenerated surgical aortic valve replacement (SAVR) is an alternative to redo-SAVR. However, reports on leaflet thrombosis following ViV-TAVI are emerging and subclinical thrombosis has gained recent attention. Although the incidence of transcatheter heart valve (THV) thrombosis after TAVI for native aortic valve disease is low, current imaging studies suggest the incidence of subclinical THV thrombosis may be significantly higher. While anticoagulation strategies for THV patients for native aortic stenosis presenting with symptomatic obstructive thrombosis has been described, the optimal management and anticoagulation therapy of patients with THV thrombosis following ViV-TAVI are less evident. Case summary We report a case series of three patients presenting with early and late THV thrombosis after ViV-TAVI. Two patients presented clinically on single antiplatelet therapy and one patient presented with subclinical valve thrombosis whilst taking a non-vitamin K oral anticoagulation agent. Discussion Leaflet thrombosis after ViV-TAVI is an important cause of THV degeneration and may present subclinically. Imaging modalities such as serial transthoracic echocardiograms and multidetector computerized tomography aid diagnosis and guide management. Patient-individualized risk- vs. -benefit prophylactic post-procedural oral anticoagulation may be indicated.

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25

Nappi, Francesco, Laura Mazzocchi, Irina Timofeva, Laurent Macron, Simone Morganti, Sanjeet Singh Avtaar Singh, David Attias, Antonio Congedo, and Ferdinando Auricchio. "A Finite Element Analysis Study from 3D CT to Predict Transcatheter Heart Valve Thrombosis." Diagnostics 10, no. 4 (March 26, 2020): 183. http://dx.doi.org/10.3390/diagnostics10040183.

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Background: Transcatheter aortic valve replacement has proved its safety and effectiveness in intermediate- to high-risk and inoperable patients with severe aortic stenosis. However, despite current guideline recommendations, the use of transcatheter aortic valve replacement (TAVR) to treat severe aortic valve stenosis caused by degenerative leaflet thickening and calcification has not been widely adopted in low-risk patients. This reluctance among both cardiac surgeons and cardiologists could be due to concerns regarding clinical and subclinical valve thrombosis. Stent performance alongside increased aortic root and leaflet stresses in surgical bioprostheses has been correlated with complications such as thrombosis, migration and structural valve degeneration. Materials and Methods: Self-expandable catheter-based aortic valve replacement (Medtronic, Minneapolis, MN, USA), which was received by patients who developed transcatheter heart valve thrombosis, was investigated using high-resolution biomodelling from computed tomography scanning. Calcific blocks were extracted from a 250 CT multi-slice image for precise three-dimensional geometry image reconstruction of the root and leaflets. Results: Distortion of the stent was observed with incomplete cranial and caudal expansion of the device. The incomplete deployment of the stent was evident in the presence of uncrushed refractory bulky calcifications. This resulted in incomplete alignment of the device within the aortic root and potential dislodgment. Conclusion: A Finite Element Analysis (FEA) investigation can anticipate the presence of calcified refractory blocks, the deformation of the prosthetic stent and the development of paravalvular orifice, and it may prevent subclinical and clinical TAVR thrombosis. Here we clearly demonstrate that using exact geometry from high-resolution CT scans in association with FEA allows detection of persistent bulky calcifications that may contribute to thrombus formation after TAVR procedure.

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26

Calik, Eyup Serhat, Husnu Kamil Limandal, Umit Arslan, Mehmet Tort, Ziya Yildiz, Ednan Bayram, Ozgur Dag, Mehmet Ali Kaygin, and Bilgehan Erkut. "Acute Mitral Valve Dysfunction Due to Escape of Prosthetic Mechanical Leaflet and Peripheral Leaftlet Embolization." Heart Surgery Forum 18, no. 6 (December 14, 2015): 245. http://dx.doi.org/10.1532/hsf.1316.

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<strong>Background:</strong> Leaflet escape of prosthetic valve is rare but potentially life threatening. Early diagnosis is essential on account of avoiding mortality, and emergency surgical correction is compulsory. This complication has previously been reported for both monoleaflet and bileaflet valve models. <br /><strong>Methods:</strong> A 30-year-old man who had undergone mitral valve replacement with a bileaflet valve 8 years prior at another center was admitted with acute-onset with cardiogenic shock as an emergency case. Transthoracic echocardiograms showed acute-starting severe mitral regurgitation associated with prosthetic mitral valve. There was a suspicious finding of a single prosthetic mitral leaflet. But the problem related with the valve wasn’t specifically determined. The patient underwent emergent surgery for replacement of the damaged prosthetic valves immediately. There was no tissue impingement and thrombosis, one of the two leaflets was absent, and there were no signs of endocarditis or pannus formation in the prosthetic valve. The missing leaflet could not be found within the cardiac cavity. The abdominal fluoroscopic study and plain radiography were unable to detect the escaped leaflet during surgery. The damaged valve was removed and a replacement 29 mm bileaflet mechanical valve was inserted by right lateral thoracotomy. <br /><strong>Results:</strong> After post-operative week one, the abdominal computed tomography scan and the ultrasound showed the escaped leaflet in the left femoral artery. Fifteen days after the surgery the escaped leaflet was removed safely from the left femoral artery and the patient made a complete recovery. <br /><strong>Conclusion:</strong> The escaped leaflet showed a fracture of one of the pivot systems caused by structural failure. Early cardiac surgery should be applied because of life-threatening problems.

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27

Raman, Jai, Jay Bhaskar, and Andrew Newcomb. "Leaflet Immobility and Hypo-Attenuated Leaflet Thrombosis (HALT)–Under-Recognised Complications of Bioprosthetic Valve Replacements." Heart, Lung and Circulation 31, no. 8 (August 2022): 1049–50. http://dx.doi.org/10.1016/j.hlc.2022.06.663.

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28

Tirilomis, Theodor. "Acute thrombosis of mechanical bi-leaflet aortic valve prosthesis." Journal of Cardiovascular Disease Research 3, no. 3 (July 2012): 228–30. http://dx.doi.org/10.4103/0975-3583.98899.

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29

Søndergaard, Lars. "Subclinical leaflet thrombosis – a concern, but also an issue?" EuroIntervention 13, no. 15 (February 2018): e1738-e1740. http://dx.doi.org/10.4244/eijv13i15a281.

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30

Doris, Mhairi Katrina, and Marc Richard Dweck. "Is bioprosthetic leaflet thrombosis a trigger to valve degeneration?" Heart 104, no. 10 (March 1, 2018): 792–93. http://dx.doi.org/10.1136/heartjnl-2017-312861.

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31

Madukauwa-David, Immanuel David, Vahid Sadri, Prem Midha, Vasilis Babaliaros, Rahul Sharma, Raj Makkar, and Ajit Yoganathan. "CORONARY FLOW INFLUENCES TRANSCATHETER AORTIC VALVE LEAFLET THROMBOSIS RISK." Journal of the American College of Cardiology 73, no. 9 (March 2019): 1035. http://dx.doi.org/10.1016/s0735-1097(19)31642-0.

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32

Makkar, Raj R., Philipp Blanke, Jonathon Leipsic, Vinod Thourani, Tarun Chakravarty, David Brown, Alfredo Trento, et al. "Subclinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic Valves." Journal of the American College of Cardiology 75, no. 24 (June 2020): 3003–15. http://dx.doi.org/10.1016/j.jacc.2020.04.043.

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33

Kuohn, Lindsey, Cezar Staniloae, Hasan Jilaihawi, Homam Ibrahim, Daniel Bamira, Illya Pushkar, Alan Vainrib, Richard Ro, Mathew Williams, and Muhamed Saric. "BIOPROSTHETIC LEAFLET THROMBOSIS AFTER TRANSCATHETER MITRAL VALVE-IN-VALVE IMPLANTATION." Journal of the American College of Cardiology 79, no. 9 (March 2022): 799. http://dx.doi.org/10.1016/s0735-1097(22)01790-9.

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34

Chasapi, Athina, Adam Hobbs, Theodore Velissaris, and Benoy N. Shah. "Sub-acute leaflet thrombosis: a reversible cause of aortic stenosis." Echo Research and Practice 5, no. 3 (September 2018): I5—I7. http://dx.doi.org/10.1530/erp-18-0032.

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35

Mangione, Fernanda M., Tannas Jatene, Alexandra Gonçalves, Gregory A. Fishbein, Richard N. Mitchell, Marc P. Pelletier, Tsuyoshi Kaneko, et al. "Leaflet Thrombosis in Surgically Explanted or Post-Mortem TAVR Valves." JACC: Cardiovascular Imaging 10, no. 1 (January 2017): 82–85. http://dx.doi.org/10.1016/j.jcmg.2016.11.009.

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36

Jilaihawi, Hasan, Federico M. Asch, Eric Manasse, Carlos E. Ruiz, Vladimir Jelnin, Mohammad Kashif, Hiroyuki Kawamori, et al. "Systematic CT Methodology for the Evaluation of Subclinical Leaflet Thrombosis." JACC: Cardiovascular Imaging 10, no. 4 (April 2017): 461–70. http://dx.doi.org/10.1016/j.jcmg.2017.02.005.

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37

Beneduce, Alessandro, Cristina Capogrosso, Stefano Stella, Francesco Ancona, Azeem Latib, Antonio Colombo, and Eustachio Agricola. "Subclinical Leaflet Thrombosis After Transcatheter Mitral Valve-in-Ring Implantation." JACC: Cardiovascular Interventions 11, no. 13 (July 2018): e105-e106. http://dx.doi.org/10.1016/j.jcin.2018.04.044.

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38

Gironi, Camilla, Laura Cercenelli, Barbara Bortolani, Nicolas Emiliani, Lorenzo Tartarini, and Emanuela Marcelli. "Innovative IntraValvular Impedance Sensing Applied to Biological Heart Valve Prostheses: Design and In Vitro Evaluation." Sensors 22, no. 21 (October 29, 2022): 8297. http://dx.doi.org/10.3390/s22218297.

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Subclinical valve thrombosis in heart valve prostheses is characterized by the progressive reduction in leaflet motion detectable with advanced imaging diagnostics. However, without routine imaging surveillance, this subclinical thrombosis may be underdiagnosed. We recently proposed the novel concept of a sensorized heart valve prosthesis based on electrical impedance measurement (IntraValvular Impedance, IVI) using miniaturized electrodes embedded in the valve structure to generate a local electric field that is altered by the cyclic movement of the leaflets. In this study, we investigated the feasibility of the novel IVI-sensing concept applied to biological heart valves (BHVs). Three proof-of-concept prototypes of sensorized BHVs were assembled with different size, geometry and positioning of the electrodes to identify the optimal IVI-measurement configuration. Each prototype was tested in vitro on a hydrodynamic heart valve assessment platform. IVI signal was closely related to the electrodes’ positioning in the valve structure and showed greater sensitivity in the prototype with small electrodes embedded in the valve commissures. The novel concept of IVI sensing is feasible on BHVs and has great potential for monitoring the valve condition after implant, allowing for early detection of subclinical valve thrombosis and timely selection of an appropriate anticoagulation therapy.

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39

Younes, Ahmad, Guilherme F. Attizzani, and Ankur Kalra. "Transcatheter Heart Valve Thrombosis: Incidence, Predictors, And Clinical Outcomes." US Cardiology Review 12, no. 1 (March 15, 2018): 33–35. http://dx.doi.org/10.15420/usc.2017:32:2.

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Since its initial approval, the number of transcatheter aortic valve replacement procedures performed has increased exponentially with evolving indications that now include patients at intermediate risk for perioperative mortality following surgery. Multiple studies and reports have observed the phenomenon of leaflet dysfunction and thrombosis on follow-up imaging that may be associated with serious adverse outcomes. This review provides an insight into the incidence, predictors, management, and follow-up of transcatheter heartvalve thrombosis.

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40

Essa, Amr, Toufik Haddad, and Terrence Slattery. "Successful Fibrinolytic Therapy in a Challenging Obstructive Prosthetic Mitral Valve Thrombosis." Journal of Investigative Medicine High Impact Case Reports 8 (January 2020): 232470962092107. http://dx.doi.org/10.1177/2324709620921078.

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Prosthetic valve thrombosis is a rare and severe complication of the mechanical prosthetic valve. Management can be challenging due to varying clinical presentation, overlapping features of differential diagnosis, and lack of randomized controlled trials on the therapeutic options. In this article, we report the case of a patient with a mechanical prosthetic mitral valve presented with symptoms of heart failure, and an echocardiography showing increased mean pressure gradient across the prosthesis along with a fixed posterior leaflet and a partially restricted anterior leaflet with no visible mass. That raised the concern for an obstructed prosthesis. After multimodality imaging and multidisciplinary team discussions, prosthetic valve thrombosis diagnosis was favored over other different diagnoses that included but not limited to pannus ingrowth. Fibrinolytic therapy was administrated, and the patient was discharged on optimal anticoagulation. Repeated echocardiography a month later showed normal mean gradient and normal functioning prosthetic mitral valve without the need for repeat mitral valve surgery.

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41

Qiu, Dong, and Ali Azadani. "TCT-360 The Importance of Leaflet Design in Initiation and Growth of Leaflet Thrombosis in Transcatheter Aortic Valves." Journal of the American College of Cardiology 80, no. 12 (September 2022): B145—B146. http://dx.doi.org/10.1016/j.jacc.2022.08.422.

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Hatoum, Hoda, Shelly Singh-Gryzbon, Philipp Ruile, Franz-Josef Neumann, Philipp Blanke, Vinod Thourani, Ajit Yoganathan, and Lakshmi Prasad Dasi. "NOVEL PREDICTIVE MODEL FOR LEAFLET THROMBOSIS IN TRANSCATHETER AORTIC VALVE REPLACEMENT." Journal of the American College of Cardiology 77, no. 18 (May 2021): 3405. http://dx.doi.org/10.1016/s0735-1097(21)04759-8.

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Bhogal, Sukhdeep, Rebecca Torguson, Paul Gordon, Afshin Ehsan, Sean R. Wilson, Robert Levitt, Puja Parikh, et al. "Subclinical Leaflet Thrombosis and Antithrombotic Therapy Post-TAVR: An LRT Substudy." Cardiovascular Revascularization Medicine 40 (July 2022): 103–4. http://dx.doi.org/10.1016/j.carrev.2022.06.234.

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Inohara, Taku, Shohei Imaeda, Yusuke Kobari, and Kentaro Hayashida. "Is Subclinical Leaflet Thrombosis Really Worth Being Treated Using Anticoagulation Therapy?" JACC: Cardiovascular Interventions 15, no. 6 (March 2022): 675–76. http://dx.doi.org/10.1016/j.jcin.2022.01.278.

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Oliveira, Dinaldo C., Sercan Okutucu, Giulio Russo, and Estevao C. Campos Martins. "The Issue of Subclinical Leaflet Thrombosis After Transcatheter Aortic Valve Implantation." Cardiology Research 11, no. 5 (2020): 269–73. http://dx.doi.org/10.14740/cr1108.

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Moral, Sergio, Juli Carballo, Esther Ballesteros, Alejandro Panaro, and Arturo Evangelista. "“Subclinical” Leaflet Thrombosis in Transcatheter Aortic Valve Implantation: A Latent Risk?" Revista Española de Cardiología (English Edition) 70, no. 6 (June 2017): 512–14. http://dx.doi.org/10.1016/j.rec.2016.08.007.

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47

Gama, Francisco, Rui Campante Teles, and Pedro Freitas. "Successful Clinical and Therapeutic Approach for Valve-in-valve Leaflet Thrombosis." Revista Española de Cardiología (English Edition) 72, no. 8 (August 2019): 673. http://dx.doi.org/10.1016/j.rec.2018.05.023.

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48

Kealhofer, Jessica V., Jeremy S. Markowitz, and Prabhjot S. Nijjar. "Use of Computed Tomography to Distinguish Thrombus from Pannus on a Bioprosthetic Aortic Valve." Texas Heart Institute Journal 46, no. 3 (June 1, 2019): 219–21. http://dx.doi.org/10.14503/thij-17-6459.

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Abstract:

Bioprosthetic valve thrombosis was previously considered to be a relatively rare complication of surgical or transcatheter bioprosthetic valve replacement. Although echocardiograms can reliably show the characteristic findings of prosthetic valve stenosis, differentiating between thrombus formation and pannus overgrowth as the underlying cause of prosthetic valve dysfunction can be challenging. We present the case of a 75-year-old man who underwent transthoracic Doppler echocardiography in the presence of an elevated valvular gradient 2 years after his aortic valve had been surgically replaced with a bioprosthesis. The echocardiographic findings suggested prosthetic valve stenosis. Cardiac computed tomography, performed to distinguish between thrombus formation and pannus overgrowth, revealed hypoattenuated leaflet thickening and reduced leaflet mobility, which suggested thrombus. After the patient took oral anticoagulants for 3 months, images showed complete resolution of the previous abnormalities, thus confirming the diagnosis of bioprosthetic valve thrombosis. We found cardiac computed tomography valuable when evaluating our patient who had an elevated prosthetic valve gradient.

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Hamadanchi, Ali, Laura Bäz, Sven Möbius-Winkler, Ulf Teichgräber, P. Christian Schulze, and Marcus Franz. "Basal leaflet thickening and color paucity in the echocardiographic evaluation of subclinical leaflet thrombosis after transcatheter aortic valve replacement." International Journal of Cardiovascular Imaging 35, no. 1 (August 14, 2018): 119–20. http://dx.doi.org/10.1007/s10554-018-1439-5.

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Pieniak, Katarzyna, Szymon Jędrzejczyk, Olaf Domaszk, Kajetan Grodecki, Bartosz Rymuza, Zenon Huczek, Janusz Kochman, Krzysztof J. Filipiak, and Aleksandra Gąsecka. "Predictors and Biomarkers of Subclinical Leaflet Thrombosis after Transcatheter Aortic Valve Implantation." Journal of Clinical Medicine 9, no. 11 (November 21, 2020): 3742. http://dx.doi.org/10.3390/jcm9113742.

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Abstract:

Transcatheter aortic valve implantation (TAVI) is a recent revolutionary treatment for high-risk patients with severe aortic stenosis who are not suitable for surgery, expanding to intermediate and low-risk patients. Valve leaflet thrombosis (LT) is a potentially fatal complication after TAVI. The incidence of subclinical LT is as high as 25% among patients in the first year after TAVI. Subclinical LT may evolve into symptomatic thrombosis or lead to premature bioprosthesis degeneration, increasing the risk of neurological complications. Because imaging-based methods have limited sensitivity to detect subclinical LT, there is an urgent need for predictors and biomarkers that would make it possible to predict LT after TAVI. Here, we summarize recent data regarding (i) patient-related, (ii) procedure-related, (iii) blood-based and (iv) imaging predictors and biomarkers which might be useful for the early diagnosis of subclinical LT after TAVI. Prevention of LT might offer an opportunity to improve risk stratification and tailor therapy after TAVI.

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