Valvular & structural heart disease
Thrombus characterisation and evolution of hypoattenuating leaflet thickening after transcatheter aortic valve implantation
Authors' conclusion
Quantitative thrombus characterisation on CTA is predictive of HALT resolution and correlates with the haemodynamic performance of transcatheter aortic valves.
Study context
- Population
- Patients who underwent computed tomography angiography (CTA) 30 days post-TAVI with balloon-expandable bioprostheses and had hypoattenuating leaflet thickening (HALT), with a second CTA at 1 yearpatients with HALT followed with a second CTA at 1 year, HALT detected in 118 (19%) of 612 patients with 30-day CTA
- Participants
- 99 patients
- Exposure
- Association between quantitative CTA features of HALT and its evolution over time
- Complete resolution of HALTn = 43
- Without complete HALT resolutionn = 56
- Outcome
- Complete resolution of HALT
- Follow-up
- 1 year
Methodological detailsprospectively followed, semiautomated software quantification
- Prospectively followed
- Semiautomated software quantification
Main finding
As reported in the abstract
- Patients with complete resolution of HALT
- 43
Observational data: associations, not effects.
Further findings
Independent predictors of HALT resolution (multivariate logistic regression)
| OR | P value | |
|---|---|---|
| Lower thrombus attenuationMultivariate logistic regression | 0.45 | P = 0.030 |
| Eccentricity indexMultivariate logistic regression | 0.42 | P = 0.003 |
| Deformation indexMultivariate logistic regression | 0.53 | P = 0.005 |
| Implant cantingMultivariate logistic regression | 1.88 | P = 0.026 |
Visual thrombus evolution in patients without complete HALT resolution
- Regression
- 48%
- Stability
- 29%
- Progression
- 23%
- Among the 56 patients without complete HALT resolution
Thrombus volume change (quantitative assessment)
- Regression: thrombus volume decrease
- 291 mm³ to 130 mm³; p=0.007
- Progression: thrombus volume increase
- 187 mm³ to 667 mm³; p=0.005
Correlation of change in thrombus volume with change in mean transvalvular gradients · between 30 days and 1 year
- R
- r=0.462; p<0.001
Original publication
Thrombus characterisation and evolution of hypoattenuating leaflet thickening after transcatheter aortic valve implantation. EuroIntervention. Published 5 May 2025. doi:10.
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