Abstract
Objective
To assess the occurrence, predictors, and outcomes of hypo-attenuated leaflet thickening (HALT) and thrombus outside the prosthetic valve following surgical aortic valve replacement.
Methods
A total of 118 patients underwent surgical aortic valve replacement with bioprosthetic valves between July 2020 and June 2022. Sixty-two (52.5%) patients, which is a fairly high number of patients, underwent cardiac computed tomography and transthoracic echocardiography one week after surgery. Patients were divided into two groups, those with HALT (n = 14) and those without HALT (n = 48).
Results
Of the 62 patients who underwent cardiac computed tomography, HALT was observed in 14 (22.5%) patients during the very early postoperative phase. Reduced leaflet motion was observed in two of the 14 patients. The low-attenuation areas were located outside the prosthetic valve in 10 cases (71.4%) in the HALT group and in 14 cases (29.2%) in the non-HALT group. More than 50% of patients (57.1%) with HALT and 79.2% without HALT were administered warfarin. Neither in-hospital deaths nor postoperative thromboembolic events were observed during hospitalization. No patient had a mean pressure gradient > 20 mmHg in either group.
Conclusion
HALT was observed in one-fifth of the cases after surgical aortic valve replacement during the very early postoperative phase in an institution wherein administration of continuous heparin infusion after surgery is a standard practice. HALT did not affect the early prognosis or incidence of cerebral infarction.
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Data availability
The deidentified participant data will be shared on a request basis. Please contact the corresponding author directly to request data sharing.
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We wish to thank Editage (www.editage.jp) for English language editing.
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TK: Conceptualization, Date curation, Formal analysis, Investigation, Writing-original draft; KT: Investigation, Supervision, Writing-review and editing; TT: Investigation, Supervision; TF: Investigation; KS: Date curation, Investigation; YZ: Investigation; TS: Investigation; KA: Investigation; ET: Investigation, Supervision, Writing-review and editing.
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Kono, T., Takagi, K., Takaseya, T. et al. Early thrombus formation including hypo-attenuated leaflet thrombosis after surgical bioprosthetic aortic valve replacement. Gen Thorac Cardiovasc Surg (2024). https://doi.org/10.1007/s11748-024-02010-4
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DOI: https://doi.org/10.1007/s11748-024-02010-4