ArticleClinical research in cardiology : official journal of the German Cardiac Society2024
Commissural misalignment independently predicts leaflet thrombosis after transcatheter aortic valve implantation.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 21 citations in OpenAlex.
- Prognostic implications and predictive factors of subclinical leaflet thrombosis following valve-in-valve transcatheter aortic valve implantation.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Trial
- Transcatheter Aortic Valve Implantation in Complex Anatomy: An Anatomy-Driven Framework for Bicuspid Stenosis, Pure Aortic Regurgitation, and the Small Annulus in the Era of Lifetime Management.Journal of clinical medicine · 2026Review
- Skirted Prosthetic Valves Are Associated With Increased Risk of Subclinical Leaflet Thrombosis Following Transcatheter Aortic Valve Replacement: A Multicenter Study.Reviews in cardiovascular medicine · 2026Article
- Post-TAVR Neo-Sinus Geometry and Impaired Ventricular Recovery Are Associated with Early Leaflet Thrombosis: First MDCT Insights from Vietnam.Journal of clinical medicine · 2026Article
- Early pannus after transcatheter heart valve implantation leading to delayed coronary obstruction: a case report.European heart journal. Case reports · 2026Article
- Commissural and Coronary Alignment Strategies in Transcatheter Aortic Valve Replacement: Success Rate and Risks.European cardiology · 2026Review
- Subclinical Leaflet Thrombosis and Subclinical Aortic Valve Complex Thrombosis in TAVR.JACC. Advances · 2025Review
- Thrombus characterisation and evolution of hypoattenuating leaflet thickening after transcatheter aortic valve implantation.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
- Clinical and structural outcomes of neocommissural alignment in transaxillary and transcarotid transcatheter aortic valve implantation with a self-expandable transcatheter heart valve.JTCVS techniques · 2023Article
- The Incidence, Impact, and Techniques of Commissural Alignment in Transcatheter Aortic Valve Implantation: A Review.Journal of clinical medicine · 2023Review
- Bioprosthetic Valves for Lifetime Management of Aortic Stenosis: Pearls and Pitfalls.Journal of clinical medicine · 2023Review
- The role of implant projection in optimizing transcatheter aortic valve implantation.REC, interventional cardiologyReview
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTranscatheter aortic valve implantation (TAVI) has become a minimally invasive alternative to surgical aortic valve replacement. Hypo-attenuated leaflet thickening (HALT)-a marker of subclinical leaflet thrombosis commonly detected by cardiac computed tomography (CT) after TAVI-may influence valve durability and function. The purpose of this study was to compare commissural alignment of the native and prosthetic aortic valves in cardiac CT in subjects with and without HALT and thereby identify commissural misalignment as potential predictor for leaflet thrombosis after TAVI. METHODS AND
resultsIn 170 subjects, 85 with and 85 without HALT in post-TAVI CT, commissural orientation of the prosthesis was determined comparing native and prosthetic aortic valve orientation in cardiac CT by measuring the commissural angle relative to the right coronary ostium in the aortic valve plane. For the prosthetic valve, any deviation ≤ 15° compared to the native valve was classified as "aligned"; 16-30° as "mild", 31-45° as "moderate" and ≥ 45° as "severe" misalignment. Among subjects with HALT, median angular deviation was higher (36°, IQR 31°) than in the control group (29°, IQR 29°, p = 0.042). "Severe" misalignment was more frequent in subjects who developed HALT (n = 31, 37%) compared to the control group (n = 17, 20%, p = 0.013). In logistic regression analysis, more severe deviation (p = 0.015, OR = 1.02 per 1° deviation) and "severe" misalignment (p = 0.018, OR = 2.2) represented independent predictors for the occurrence of HALT after TAVI.
conclusionSubclinical leaflet thrombosis after TAVI is associated with commissural misalignment. Potential clinical advantages of obtaining commissural alignment remain to be systematically assessed.
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