{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:55:54Z","timestamp":1790070954067,"version":"4.0.1"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"\n Background<\/jats:title>\n \n The prevalence of hypo\u2010attenuated leaflet thickening (\n HALT<\/jats:styled-content>\n ) and reduced leaflet motion (\n RLM<\/jats:styled-content>\n ) is unknown in surgically implanted bioprostheses because systematic investigation of\n HALT<\/jats:styled-content>\n and\/or\n RLM<\/jats:styled-content>\n is limited to a few catheter\u2010based valves. The aim of this study was to investigate the prevalence of\n HALT<\/jats:styled-content>\n and\n RLM<\/jats:styled-content>\n by cardiac computed tomography in patients who underwent surgical aortic valve replacement and received a Perceval sutureless aortic valve bioprosthesis.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n This was a single\u2010center prospective observational study that included 47 patients (83.5% of the total number of implantations) who underwent surgical aortic valve replacement with implantation of the Perceval sutureless bioprosthesis (LivaNova PLC, London, UK) at Karolinska University Hospital in Stockholm, Sweden from 2012 to 2016 and were studied by cardiac computed tomography. Cardiac computed tomography was performed at a median of 491\u00a0days (range 36\u20131247\u00a0days) postoperatively.\n HALT<\/jats:styled-content>\n was found in 18 (38%) patients and\n RLM<\/jats:styled-content>\n in 13 (28%) patients. All patients with\n RLM<\/jats:styled-content>\n had\n HALT<\/jats:styled-content>\n . Among patients with\n HALT<\/jats:styled-content>\n , 5 out of 18 patients (28%) were treated with anticoagulation (warfarin or any novel oral anticoagulant) at the time of cardiac computed tomography. Among patients with\n RLM<\/jats:styled-content>\n , 3 out of 13 patients (23%) were treated with anticoagulation.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n HALT<\/jats:styled-content>\n and\n RLM<\/jats:styled-content>\n were prevalent in the surgically implanted Perceval sutureless aortic valve bioprosthesis. Both\n HALT<\/jats:styled-content>\n and\n RLM<\/jats:styled-content>\n were found in patients with ongoing anticoagulation treatment. Whether these findings are associated with adverse events needs further study.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n . Unique identifier:\n NCT<\/jats:styled-content>\n 02671474.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.005251","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T18:25:38Z","timestamp":1504290338000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Hypo\u2010Attenuated Leaflet Thickening and Reduced Leaflet Motion in Sutureless Bioprosthetic Aortic Valves"],"prefix":"10.1161","volume":"6","author":[{"given":"Magnus","family":"Dal\u00e9n","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrik","family":"Sartipy","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Cederlund","sequence":"additional","affiliation":[{"name":"Department of Radiology Huddinge, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Franco\u2010Cereceda","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Radiology Huddinge, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Themudo","sequence":"additional","affiliation":[{"name":"Department of Radiology Huddinge, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Svenarud","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin","family":"Bacsovics Brolin","sequence":"additional","affiliation":[{"name":"Department of Radiology Huddinge, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv526"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509233"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.001596"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(17)30757\u20102"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1512264"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euje.2005.11.002"},{"key":"e_1_3_4_8_2","first-page":"526","article-title":"Successful thrombolysis of late, non\u2010obstructive mitral bioprosthetic valve thrombosis: case report and review of the literature","volume":"20","author":"Pozsonyi Z","year":"2011","unstructured":"Pozsonyi Z, Lengyel M. Successful thrombolysis of late, non\u2010obstructive mitral bioprosthetic valve thrombosis: case report and review of the literature. J Heart Valve Dis. 2011;20:526\u2013530.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.071183"},{"key":"e_1_3_4_10_2","unstructured":"LivaNova PLC announces the first patient enrolled in the PERSIST\u2010AVR Trial. Available at: http:\/\/www.livanova.com\/investor-relations\/pressreleases\/news_release_2153818. Accessed May 21 2016."},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.12.064"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.168237"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2010.09.008"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.08.010"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.11.005"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.126.6.1938"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.02.536"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs109"},{"key":"e_1_3_4_19_2","unstructured":"Perceval sutureless aortic heart valve instructions for use. Available at: http:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf15\/P150011d.pdf. 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