Valvular & structural heart disease
Prognostic implications and predictive factors of subclinical leaflet thrombosis following valve-in-valve transcatheter aortic valve implantation
Main finding · Composite of all-cause mortality, hospitalisation for heart failure (HF), or strokeResult — go to the resultOdds ratio 2.31 95% CI 1.04–5.15Authors' conclusion
HALT was frequently observed in patients who underwent ViV TAVI. Additionally, the presence of HALT correlated with a higher incidence of composite outcomes, including all-cause mortality, hospitalisation for HF, and stroke. Assessment of TRanscathetEr and Surgical Aortic BiOprosthetic VaLVe Dysfunction and Its TrEatment with Anticoagulation (RESOLVE; ClinicalTrials.gov: NCT02318342).
Study context
- Population
- Patients who underwent valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) with balloon-expandable valvespatients analysed, hypoattenuated leaflet thickening (HALT) detected in 37 (31.6%)
- Participants
- 117 patients
- Exposure
- Patients with and without HALT
- HALTn = 37
- Outcome
- Composite of:
- All-cause mortality
- Hospitalisation for heart failure (HF)
- Stroke
- Follow-up
- 3 years
Methodological detailssingle-centre (Cedars-Sinai Medical Center), pre- and postprocedural computed tomography (CT)
- Single-centre (Cedars-Sinai Medical Center)
- Pre- and postprocedural CT
Main finding
As reported in the abstract
Odds ratio
2.31
95% CI 1.04–5.15
P = 0.04
HALTvs No HALT
OR 2.31 (95% CI 1.04–5.15); P = 0.04
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality | 1.13 (0.42–3.02) | P = 0.8 | |
| 0.20.5125Odds ratio (log scale) |
- HALT incidence · 1 month after ViV TAVI
- 31.6% · 37
Predictors of HALT (multivariable analysis)
- Anticoagulation therapy: OR 0.28
- P = 0.037 (95% CI 0.08-0.92)
- Greater transcatheter heart valve (THV) expansion at the minimum area level: OR 0.95
- P = 0.026 (95% CI 0.91-0.99)
- Significant predictors of reduced HALT following ViV TAVI
Original publication
Prognostic implications and predictive factors of subclinical leaflet thrombosis following valve-in-valve transcatheter aortic valve implantation. EuroIntervention. Published 5 May 2025. doi:10.
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