title: Early aortic transcatheter heart valve thrombosis: diagnostic value of contrast-enhanced multidetector computed tomography.
abstract: BACKGROUND
  Early stent valve thrombosis after transcatheter aortic valve implantation (TAVI) is a rare complication, which is diagnosed based on the appearance of clinical symptoms of heart failure and echocardiographic findings. After TAVI, transthoracic echocardiography is performed to assess transcatheter heart valve (THV) function. However, preliminary reports indicate the potential additive clinical value of multidetector computed tomography (MDCT) for the diagnosis of THV thrombosis. We sought to determine the value of MDCT for the diagnosis of THV thrombosis and the frequency of this complication after balloon-expandable TAVI.
  
  
  RESULTS
  MDCT was performed in 140 patients within 1 to 3 months after TAVI with the Edwards Sapien XT THV to assess the presence of THV thrombosis and THV stent geometry. Post-TAVI MDCT identified THV thrombosis in 5 patients (4%). Of note, 4 of these patients were asymptomatic and had a normal transthoracic echocardiographic examination without signs of thrombus formation or flow obstruction. In patients with THV thrombosis, a left ventricular ejection fraction of <35% was present in 3 (60%), whereas 2 (40%) did not receive standard post-TAVI dual-antiplatelet therapy. Neither THV underexpansion nor THV noncircularity was detected in patients with THV thrombosis.
  
  
  CONCLUSIONS
  Post-TAVI MDCT is a valuable tool for the diagnosis of THV thrombosis, and this complication seems to be more common than previously anticipated. Larger studies are required to identify specific risk factors of THV thrombosis.
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: Tina
authors: T
authors: Leetmaa
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.). nh@dadlnet.dk.
authors: Nicolaj C
authors: NC
authors: Hansson
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: Jonathon
authors: J
authors: Leipsic
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: Kaare
authors: K
authors: Jensen
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: Steen H
authors: SH
authors: Poulsen
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: Henning R
authors: HR
authors: Andersen
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: Jesper M
authors: JM
authors: Jensen
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: John
authors: J
authors: Webb
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: Philipp
authors: P
authors: Blanke
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: Mariann
authors: M
authors: Tang
authors: From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.).
authors: Bjarne L
authors: BL
authors: Nørgaard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000601:surgery; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D015607:Stents / Q000706:statistics & numerical data; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology; D065467:Transcatheter Aortic Valve Replacement
keywords: aortic valve stenosis; multislice computed tomography; thrombosis; transcatheter aortic valve replacement