The impact of hypo-attenuated leaflet thickening on haemodynamic valve deterioration following transcatheter aortic valve replacement

This figure demonstrates the continuum of leaflet thrombosis. Previous studies have shown that prostheses that develop hypo-attenuated leaflet thickening (HALT) may progress to restricted leaflet motion (RELM), which is associated with an increased thrombotic burden. Whether this progresses to bioprosthetic valve failure or valve thrombosis is unclear. In this study, HALT was shown to be an independent predictor of haemodynamic valve deterioration (HVD). Furthermore, a cumulative HALT depth of greater than 2.4 ​mm and cumulative area greater than 28 ​mm2 accurately predicted HVD. Patients with HALT that develop HVD may progress to bioprosthetic valve failure and clinical valve thrombosis if left unmonitored or untreated. HALT ​= ​hypo-attenuated leaflet thickening, HVD ​= ​haemodynamic valve deterioration, RELM ​= ​reduced leaflet motion.Image 1