Valvular & structural heart diseaseCohort study
Impact of Leaflet Modification on the Occurrence of Hypoattenuated Leaflet Thickening After Valve-in-Valve Transcatheter Aortic Valve Replacement
- Retrospective cohort study
Authors' conclusion
In patients undergoing ViV TAVR, intentional leaflet modification is associated with a significantly reduced incidence of HALT, suggesting a protective association with subclinical leaflet thrombosis.
Study context
- Population
- Patients undergoing valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) for failed bioprosthetic valves with postprocedural multidetector CT
- Participants
- 141 patients
- Exposure
- Leaflet modification vs standard ViV TAVR without leaflet modification
- Leaflet modificationn = 61
- Standard ViV TAVRn = 80reference
- Outcome
- Incidence of HALT
Main finding
As reported in the abstract
HALT
P < 0.01
Observational data: associations, not effects.
Further findings
Postprocedural mean transvalvular gradient
P < 0.001
HALT involving multiple leaflets
P = 0.054
Hypoattenuated leaflet thickening (HALT) with dual-leaflet modification (subgroup)
- No cases of HALT with dual-leaflet modification
Reduced leaflet motion in patients with HALT
- Identified in one-third of patients with HALT; no significant difference between groups
Original publication
Impact of Leaflet Modification on the Occurrence of Hypoattenuated Leaflet Thickening After Valve-in-Valve Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. Published 8 June 2026. doi:10.1016/j.jcin.2026.01.313
Summarised from the published abstract; every number is checked against it