{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:28:02Z","timestamp":1793824082677,"version":"4.6.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,12,6]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Subclinical leaflet thrombosis, characterized by hypoattenuated leaflet thickening (HALT) on multidetector computed tomography, is common after transcatheter aortic valve replacement (TAVR). Because little is known about the long\u2010term natural history of subclinical HALT, we aimed to investigate this in patients who underwent TAVR without using additional anticoagulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We retrospectively evaluated patients who underwent TAVR with the Edwards SAPIEN\u2010XT at our institute between October 2013 and December 2015. Patients were grouped according to the presence or absence of HALT within 1\u2009year after TAVR (HALT and No\u2010HALT groups). The primary outcome, defined as the composite of all\u2010cause mortality, heart failure readmission, and ischemic stroke, was compared. Valve performance was assessed over time by transthoracic echocardiography. Among 124 patients (men: 29.1%; median age, 85\u2009years), 27 (21.8%) showed HALT on multidetector computed tomography within 1\u2009year after TAVR. No patient required additional anticoagulation for treating HALT because of the absence of valve\u2010related symptomatic deterioration. During the median follow\u2010up period of 4.7\u2009years (interquartile range, 4.0\u20135.6), the rate of primary outcome and valve performance was not statistically different between the 2 groups (37.0% versus 38.1%; log\u2010rank test\n                      <jats:italic>P<\/jats:italic>\n                      =0.92; mean pressure gradient, 9\u2009mm\u2009Hg [8\u201314\u2009mm\u2009Hg] versus 10\u2009mm\u2009Hg [7\u201315\u2009mm\u2009Hg];\n                      <jats:italic>P<\/jats:italic>\n                      =0.51, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Approximately 20% of patients after TAVR had HALT within 1\u2009year; however, that did not change the risk of subsequent adverse cardiovascular events or the valve performance with statistical significance for up to 5\u2009years despite no additional anticoagulation therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.026334","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T06:10:09Z","timestamp":1669702209000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Natural History of Leaflet Thrombosis After Transcatheter Aortic Valve Replacement: A 5\u2010Year Follow\u2010Up Study"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6211-1617","authenticated-orcid":false,"given":"Shohei","family":"Imaeda","sequence":"first","affiliation":[{"name":"Department of Cardiology Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7889-2083","authenticated-orcid":false,"given":"Taku","family":"Inohara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Yoshijima","sequence":"additional","affiliation":[{"name":"Department of Cardiology Saiseikai Utsunomiya Hospital Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6144-9747","authenticated-orcid":false,"given":"Yusuke","family":"Kobari","sequence":"additional","affiliation":[{"name":"Department of Cardiology Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sosuke","family":"Myojin","sequence":"additional","affiliation":[{"name":"Department of Cardiology Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6450-860X","authenticated-orcid":false,"given":"Toshinobu","family":"Ryuzaki","sequence":"additional","affiliation":[{"name":"Department of 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