Key result
Post-TAVI subclinical leaflet thrombosis is common, but clinical impact and optimal treatment remain uncertain.
Why the study?
Whether subclinical leaflet thrombosis after TAVI reduces valve durability and increases stroke risk remains debated, with uncertainty regarding optimal post-TAVI antithrombotic therapy.
Subclinical leaflet thrombosis (SLT) is a recognized phenomenon after TAVI diagnosed primarily by CT, but its clinical impact on stroke and valve durability remains debated, and routine anticoagulation is not currently recommended.
Should not alter post-TAVI antithrombotic strategies; leaves open the clinical impact of subclinical leaflet thrombosis and need for targeted trials.
In recent years, the phenomenon of subclinical leaflet thrombosis (SLT) in patients who have undergone transcatheter aortic valve implantation has become increasingly relevant. Hypo-attenuating leaflet thickening and hypo-attenuation affecting motion diagnosed by CT are the hallmarks of SLT, and their incidence varies depending on the intensity of screening. Whether these phenomena are a surrogate for leaflet thrombosis reducing valve durability and increasing the risk of stroke is still a matter of debate. Uncertainty remains over the optimal antithrombotic therapy after TAVI and the best treatment strategy is still not confirmed. Ongoing and future trials will provide more evidence about the best strategy for the prevention and treatment of SLT.
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Martı́n et al. (2021) conducted a review in Subclinical and clinical leaflet thrombosis after transcatheter aortic valve implantation (TAVI). Transcatheter Aortic Valve Implantation (TAVI) was evaluated. Subclinical leaflet thrombosis is a frequent imaging finding after transcatheter aortic valve implantation, but its clinical consequences and optimal antithrombotic treatment remain uncertain.
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