AI Article Synopsis
- Subclinical leaflet thrombosis (SLT) can lead to failure of transcatheter heart valves (THV) after TAVI, prompting this study to investigate its formation and related thrombotic factors.
- In a study of 26 patients treated with edoxaban for atrial fibrillation undergoing TAVI, SLT was observed in 16.7% of patients at one week, decreasing to 5.9% by three months.
- It was found that patients with SLT at one week had reduced maximal leaflet thickness, while thrombogenicity initially dropped but began to rise again by three months post-TAVI, indicating complex dynamics in thrombus formation in the early recovery phase.
Article Abstract
Subclinical leaflet thrombosis (SLT) can be one of the causes of transcatheter heart valve (THV) failure after transcatheter aortic valve implantation (TAVI). We sought to clarify the formation process of SLT and thrombogenicity during the perioperative period of TAVI. This multicenter, prospective, single-arm interventional study enrolled 26 patients treated with edoxaban for atrial fibrillation and who underwent TAVI for severe aortic stenosis between September 2018 and September 2022. We investigated changes in maximal leaflet thickness detected by contrast-enhanced computed tomography between 1 week and 3 months after TAVI in 18 patients and measured the thrombogenicity by Total Thrombus-formation Analysis System (T-TAS) and flow stagnation volume by computational fluid dynamics (CFD) (n = 11). SLT was observed in 16.7% (3/18) at 1 week, but decreased to 5.9% (1/17) at 3 months after TAVI. Patients with SLT at 1 week had a significantly decreased maximal leaflet thickness compared to those without SLT. Thrombogenicity assessed by T-TAS decreased markedly at 1 week and tended to increase at 3 months. The stagnation volume assessed by CFD was positively associated with a higher maximum leaflet thickness. This study showed the course of leaflet thrombus formation and visualization of stagnation in neo-sinus of THV in the acute phase after TAVI.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11213935 | PMC |
| http://dx.doi.org/10.1038/s41598-024-65600-5 | DOI Listing |
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