ArticleJACC. Case reports2026
Obstructive Hypoattenuated Leaflet Thickening in a Complex Valve-in-Valve TAVR Successfully Treated With Thrombolysis.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Thrombolysis for Obstructive HALT in Complex Valve-in-Valve TAVR.JACC. Case reports · 2026Article
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundHypoattenuated leaflet thickening (HALT) is an important cause of bioprosthetic valve dysfunction after transcatheter aortic valve replacement. CASE SUMMARY: A woman in her mid-70s developed 1 week of exertional dyspnea and chest tightness 5 years after a complicated transcatheter aortic valve replacement in which a migrated 26-mm Medtronic Evolut PRO+ valve was snared into the distal ascending aorta, and a second 26-mm Evolut PRO+ valve was placed across the annulus. Echocardiography showed severe prosthetic valve obstruction, and computed tomography angiography revealed overlapping frames with leaflet hypoattenuation consistent with HALT. She received ultraslow, low-dose alteplase over 48 hours, followed by apixaban, resulting in marked improvement (mean gradient decreased from 66 to 28 mm Hg). DISCUSSION: Although HALT may resemble structural valve degeneration, it can respond well to medical therapy in selected patients with high procedural risk. TAKE-HOME MESSAGE: Ultraslow, low-dose thrombolysis followed by anticoagulation can safely restore function in obstructive HALT when reoperation is prohibitive.
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