{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T03:06:26Z","timestamp":1761102386030,"version":"3.40.5"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T00:00:00Z","timestamp":1579478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Leaflet thrombosis (LT, also called cusp thrombosis) detected by multidetector computed tomography (MDCT) is common in bioprosthetic aortic valve replacement (bAVR). However, it remains contradictory whether MDCT\u2010defined LT following bAVR is associated with hemodynamic deterioration and stroke. Thus, we performed the first meta\u2010analysis to assess hemodynamic outcomes and updated the latest researches on the clinical outcomes of MDCT\u2010defined LT after bAVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>MDCT\u2010defined LT might be associated with worse hemodynamic and clinical outcomes after bAVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>MEDLINE, EMBASE, Cochrane Library, and <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrial.gov\">ClinicalTrial.gov<\/jats:ext-link> were searched from inception to 15th April 2019. The fix\u2010effect model was utilized to calculate odds ratio (OR) and 95% confidence interval (CI). The primary outcomes were hemodynamic stability indexes, including mean pressure gradient (MPG), left ventricular ejection fraction (LVEF), paravalvular leak (PVL), and clinical heart failure. The secondary endpoints were major adverse cardiovascular and cerebrovascular events (MACCEs), which consisted of myocardial infarction, all\u2010cause death, stroke, and transient ischemic attack (TIA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve studies with 4820 patients were included. The total prevalence of MDCT\u2010defined LT was 9.7%. MDCT\u2010defined LT was associated with a significantly increased risk of MPG (inverse variance 0.43, 95% CI: [0.30, 0.57]), MACCEs (OR 2.43, 95% CI: [1.45, 4.06]), stroke (OR 1.79, 95% CI: [1.03, 3.11]), and TIA (OR 4.09, 95% CI: [1.59, 10.54]). There were no differences for other outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MDCT\u2010defined LT after bAVR is associated with increased MPG and increased risk of adverse cerebrovascular events, including TIA and stroke. While LVEF, PVL, and clinical heart failure were similar between patient with and without LT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23331","type":"journal-article","created":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T10:14:50Z","timestamp":1579515290000},"page":"468-474","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of leaflet thrombosis on hemodynamics and clinical outcomes after bioprosthetic aortic valve replacement: A meta\u2010analysis"],"prefix":"10.1002","volume":"43","author":[{"given":"Zixin","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Cardiology Shengjing Hospital of China Medical University  Shengyang Liaoning Province People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiejun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology Shengjing Hospital of China Medical University  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