About different localization of hypoattenuated lesions following transcatheter aortic valve replacement
Copyright © 2023 Elsevier B.V. All rights reserved..
BACKGROUND: Subclinical leaflet thrombosis is diagnosed using multidetector computed tomography (MDCT) and is characterised by a meniscal-shaped hypoattenuated lesion of one or more leaflets. Transcatheter aortic self-expandable valves are commonly manufactured with pliable pericardium over a nitinol frame that forms leaflet and extra-leaflet components such as the valve skirt. Little is known about extra-leaflet hypoattenuated lesion localisation, including that at the anatomical sinus level. Thus, the main aim of this study was to describe leaflet and extra-leaflet (anatomic sinus and subvalvular level) hypoattenuated lesions following transcatheter aortic valve replacement with a self-expandable prosthesis. As a secondary aim, we sought to investigate predictors of hypoattenuated lesions.
METHODS: Fifty patients underwent MDCT at the follow-up.
RESULTS: At a follow-up of 12 months, hypoattenuated leaflet lesions with mild to severe restricted movement were detected in eight individuals (16%), anatomic sinus lesions were identified in nine patients (18%), with higher prevalence in the non-coronary sinus (16%), and subvalvular lesions with variable extension toward the valve inflow were diagnosed in eight patients (16%). In 4 patients (8%) the anatomic sinus thrombus was 'in overlap' with leaflet thrombus; in 3 patients (6%) was in continuity with subvalvular frame thrombus. Bicuspid valve was the only independent predictor associated with hypoattenuated lesions (adj OR 8.25 (95% CI: 1.38, 49.21), p = 0.02)).
CONCLUSIONS: This study demonstrated that hypoattenuated lesions could be identified not only at the leaflet but also at the subvalvular and anatomic sinus levels. The clinical relevance of such lesions remains unclear.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:398 |
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| Enthalten in: |
International journal of cardiology - 398(2024) vom: 01. Jan., Seite 131597 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Moscarelli, Marco [VerfasserIn] |
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| Links: |
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| Themen: |
Hypoattenuated lesions |
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| Anmerkungen: |
Date Completed 23.01.2024 Date Revised 23.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijcard.2023.131597 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364713224 |
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| 245 | 1 | 0 | |a About different localization of hypoattenuated lesions following transcatheter aortic valve replacement |
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| 520 | |a Copyright © 2023 Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Subclinical leaflet thrombosis is diagnosed using multidetector computed tomography (MDCT) and is characterised by a meniscal-shaped hypoattenuated lesion of one or more leaflets. Transcatheter aortic self-expandable valves are commonly manufactured with pliable pericardium over a nitinol frame that forms leaflet and extra-leaflet components such as the valve skirt. Little is known about extra-leaflet hypoattenuated lesion localisation, including that at the anatomical sinus level. Thus, the main aim of this study was to describe leaflet and extra-leaflet (anatomic sinus and subvalvular level) hypoattenuated lesions following transcatheter aortic valve replacement with a self-expandable prosthesis. As a secondary aim, we sought to investigate predictors of hypoattenuated lesions | ||
| 520 | |a METHODS: Fifty patients underwent MDCT at the follow-up | ||
| 520 | |a RESULTS: At a follow-up of 12 months, hypoattenuated leaflet lesions with mild to severe restricted movement were detected in eight individuals (16%), anatomic sinus lesions were identified in nine patients (18%), with higher prevalence in the non-coronary sinus (16%), and subvalvular lesions with variable extension toward the valve inflow were diagnosed in eight patients (16%). In 4 patients (8%) the anatomic sinus thrombus was 'in overlap' with leaflet thrombus; in 3 patients (6%) was in continuity with subvalvular frame thrombus. Bicuspid valve was the only independent predictor associated with hypoattenuated lesions (adj OR 8.25 (95% CI: 1.38, 49.21), p = 0.02)) | ||
| 520 | |a CONCLUSIONS: This study demonstrated that hypoattenuated lesions could be identified not only at the leaflet but also at the subvalvular and anatomic sinus levels. The clinical relevance of such lesions remains unclear | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Hypoattenuated lesions | |
| 650 | 4 | |a Subclinical leaflet thrombosis | |
| 650 | 4 | |a Transcatheter aortic valve replacement | |
| 700 | 1 | |a Sollami, Giulia |e verfasserin |4 aut | |
| 700 | 1 | |a Lentini, Emanuele |e verfasserin |4 aut | |
| 700 | 1 | |a Prestera, Rosa |e verfasserin |4 aut | |
| 700 | 1 | |a Pernice, Vincenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Milo, Sabrina |e verfasserin |4 aut | |
| 700 | 1 | |a Violante, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Cuffari, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Di Pasquale, Claudia |e verfasserin |4 aut | |
| 700 | 1 | |a Ferlisi, Angelo |e verfasserin |4 aut | |
| 700 | 1 | |a La Grutta, Ludovico |e verfasserin |4 aut | |
| 700 | 1 | |a Grassedonio, Emanuele |e verfasserin |4 aut | |
| 700 | 1 | |a Speziale, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Fattouch, Khalil |e verfasserin |4 aut | |
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