Hypoattenuated Leaflet Thickening: A Comprehensive Review of Contemporary Data

J Cardiothorac Vasc Anesth. 2024 Nov;38(11):2761-2769. doi: 10.1053/j.jvca.2024.06.043. Epub 2024 Jul 2.

Abstract

Nearly one-third of patients who undergo surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) develop hypoattenuated leaflet thickening (HALT) within a year. HALT typically represents subclinical leaflet thrombosis in asymptomatic patients, and as a result it often is detected incidentally. However, HALT also may worsen in severity, resulting in leaflet immobility and/or valve deterioration. The clinical significance of HALT is a topic of ongoing debate, and currently there is no consensus on the screening and management of HALT in patients following TAVR or SAVR. This review provides a comprehensive evaluation of the available evidence on risk factors, preventative measures, treatment, and prognosis for this growing patient cohort.

Keywords: aortic valve replacement; hypo-attenuated leaflet thickening; leaflet thrombosis; transcatheter aortic valve replacement.

Publication types

  • Review

MeSH terms

  • Aortic Valve Stenosis / surgery
  • Aortic Valve* / diagnostic imaging
  • Aortic Valve* / surgery
  • Heart Valve Prosthesis Implantation / adverse effects
  • Heart Valve Prosthesis Implantation / methods
  • Humans
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • Transcatheter Aortic Valve Replacement* / methods