Assessing the Risk of Leaflet Motion Abnormality Following Transcatheter Aortic Valve Implantation
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Key result
Leaflet motion abnormalities and subclinical thrombosis are detected by CT in 10-15% of patients after transcatheter aortic valve implantation, but routine anticoagulation is not currently recommended.
Population
Patients undergoing transcatheter aortic valve implantation (TAVI)
Design
Review
Authors
Discussion
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Implication
Does not support routine CT screening or anticoagulation post-TAVI; leaves open clinical relevance of subclinical thrombosis pending outcome linkage.
Structured PICO
P
Population
Patients undergoing transcatheter aortic valve implantation (TAVI)
E
Exposure
Screening for leaflet motion abnormalities (using CT or echocardiography) and subsequent management with anticoagulation
Routine CT screening for subclinical leaflet thrombosis post-TAVI and routine anticoagulation are not currently recommended until robust evidence links these imaging findings to clinical events.
Limitations
- Consensus of definitions and quantification of leaflet thrombosis with CT is lacking
- The optimal CT timing after TAVI to detect meaningful leaflet thrombosis is unknown
- Predictors of subclinical TAV thrombosis are unknown
Cite This Study
Testa et al. (2017) conducted a review in Leaflet motion abnormalities following transcatheter aortic valve implantation. Transcatheter Aortic Valve Implantation (TAVI) was evaluated. Leaflet motion abnormalities and subclinical thrombosis are detected by CT in 10-15% of patients after transcatheter aortic valve implantation, but routine anticoagulation is not currently recommended.
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