Silent Valsalva thrombus between the native Valsalva and balloon-expandable transcatheter heart valve: multicentre Japanese registry analysis
Autor: | Futoshi Yamanaka, Toru Naganuma, Tetsuro Shimura, Akihiro Higashimori, Ryo Yanagisawa, Yusuke Watanabe, Masanori Yamamoto, Toshiaki Otsuka, Kentaro Hayashida, Motoharu Araki, Tatsuya Tsunaki, Kazuki Mizutani, Ai Kagase |
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Rok vydání: | 2019 |
Předmět: |
Aortic valve
medicine.medical_specialty Thrombogenicity Prosthesis Design Transcatheter Aortic Valve Replacement Japan Internal medicine Multidetector Computed Tomography medicine Humans Registries cardiovascular diseases Heart valve Thrombus Stroke Retrospective Studies business.industry Thrombosis Aortic Valve Stenosis medicine.disease Treatment Outcome medicine.anatomical_structure Aortic Valve Heart Valve Prosthesis Aortic valve stenosis Heart failure cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology |
Zdroj: | EuroIntervention. 15:892-899 |
ISSN: | 1774-024X |
Popis: | The newly formed geometry between the native Valsalva and implanted transcatheter heart valve (THV) may induce local thrombogenicity. This study aimed to assess the incidence of and the clinical outcomes associated with Valsalva thrombus formation after transcatheter aortic valve implantation (TAVI).We retrospectively evaluated the multidetector computed tomography (MDCT) data of 338 patients following transcatheter aortic valve implantation (TAVI) using a balloon-expandable THV. The Valsalva and leaflet thrombi were assessed by MDCT at the left coronary cusp (LCC), right coronary cusp (RCC), and non-coronary cusp (NCC). Combined endpoints such as death, stroke, and readmission for heart failure rates in patients with and without Valsalva and/or leaflet thrombus were examined at two years. The overall incidence of Valsalva and leaflet thrombi was 8.9% and 8.3%, respectively. Significant differences in the location of the Valsalva thrombus in the LCC, RCC, and NCC were noted (5.0%, 4.2%, 8.9%, respectively, p0.001). The independent predictor for increased risk of Valsalva thrombus was high Valsalva area to implanted THV size ratio (odds ratio 11.8, 95% confidence interval [CI]: 1.67-83.0, p=0.013). Combined endpoints were similar in patients with and without Valsalva thrombus, Valsalva/leaflet thrombus, and leaflet thrombus (p0.05 for all).Valsalva thrombus was detected in 8.9% of patients following balloon-expandable THV implantation and was common in the LCC, but it did not increase the risk of adverse events after TAVI. |
Databáze: | OpenAIRE |
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