Author + information
- Elizabeth Mary Holpera,b,
- Kathryn Hebelera,b,
- Deepika Gopala,b,
- William Brinkmana,b,
- Molly Szerlipa,b,
- Cecile Mahoneya,b,
- David Browna,b,
- Paul Grayburna,b,
- Michael Macka,b and
- Ambarish Gopala,b
Background: The incidence of valve thrombosis after transcatheter aortic valve replacement (TAVR) and surgical AVR (SAVR) when referred for clinical and echocardiographic indications, as well as response to anticoagulation is unknown.
Methods: Between 11/2015 and 10/2016, all patients with clinical or echo indications were evaluated by 4D CT for leaflet abnormalities in bioprosthetic TAVR and SAVR valves. Patients with the following indications were studied: 1) Increase in mean gradient of at least 10 mmHg compared to previous transthoracic echo (TTE); 2) Decrease in ejection fraction (≥10 points); 3) Thrombus seen on TTE; 4) A persistent or increasing paravalvular leak (PVL); 5) Clinical indication; or 6) Structural abnormalities. 74 patients (41 TAVR and 33 SAVR) were studied by 4D CT valve imaging, which was performed using a 256-slice CT scanner.
Results: Possible leaflet thrombosis was seen in 13/41 (31.2%) of TAVR and 13/33 (39.4%) of SAVR patients. Indications for CT, time to imaging, and treatment methods are seen in the table. Follow-up imaging after 3 months was available for 3 TAVR patients, all with complete resolution of thrombus following warfarin therapy. Further follow-up will be presented
Conclusions: When 4DCT is performed “for cause”, 35% of patients were found to have likely aortic valve leaflet thrombus. The clinical sequelae and recommended treatment and imaging follow-up of thrombosis in TAVR and SAVR bioprostheses require further study.
Moderated Poster Contributions
Valvular Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 4:00 p.m.-4:10 p.m.
Session Title: Prosthetic Valve Thrombosis: TAVR, Bio, Mech… Now What?!
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1260M-05
- 2017 American College of Cardiology Foundation