ArticleJACC. Case reports2026
A Very Late Mitral Valve Hypoattenuated Leaflet Thickening With Significant Warfarin Response.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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5 authors.
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Abstract
backgroundHypoattenuated leaflet thickening (HALT) represents subclinical leaflet thrombosis in bioprosthetic valves with risk of occurrence peaking at 12 to 24 months after implantation. However, late presentations can occur. CASE SUMMARY: A 77-year-old woman developed severe mitral stenosis 17 years after receiving a bioprosthetic mitral valve. Cardiac CT revealed extensive hypoattenuated leaflet thrombosis affecting all leaflets. After 3 months of therapeutic warfarin, repeat imaging demonstrated significant HALT resolution, avoiding valve-in-valve intervention. DISCUSSION: This represents an unusual late HALT presentation, causing bioprosthetic mitral valve dysfunction, which exceeds usual follow-up periods. The significant response to warfarin supports anticoagulation effectiveness and thrombotic etiology. TAKE-HOME MESSAGES: Since HALT can occur very late after valve replacement, long-term monitoring needs to be considered. Warfarin anticoagulation can effectively resolve HALT even in late presentations, helping to avoid surgical intervention.
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