Improving the Function of Thrombosed Aortic Bioprosthetic Valves through Anticoagulation

Hypoattenuated leaflet thickening (HALT), a potential aftereffect of both surgical and transcatheter bioprosthetic aortic valve procedures, may affect valve performance and clinical outcomes. Here, we describe an elderly patient who, underwent surgical aortic valve replacement with a bioprosthetic valve for aortic stenosis (SAVR), was hospitalized due to heart failure, and complained of worsening dyspnea. The patient’s echocardiography showed an elevated pressure gradient in the aortic valve, while CT revealed HALT on the right coronary cusp of the aortic bioprosthetic valve. Following the diagnosis of a thrombosed bioprosthetic valve, anticoagulation therapy with Coumadin was initiated. The patient's dyspnea symptoms improved, and echocardiography revealed a decreased pressure gradient in the aortic valve three months after starting anticoagulation therapy. This case highlights the significance of considering anticoagulation as the primary treatment option for patients with HALT of a bioprosthetic aortic valve.