Department of Anesthesiology, Albany Medical Center, Albany, NY.
University of South Florida Morsani College of Medicine, Tampa, FL.
J Cardiothorac Vasc Anesth. 2024 Nov;38(11):2761-2769. doi: 10.1053/j.jvca.2024.06.043. Epub 2024 Jul 2.
Nearly one-third of patients who undergo surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) develop hypoattenuated leaflet thickening (HALT) within a year. HALT typically represents subclinical leaflet thrombosis in asymptomatic patients, and as a result it often is detected incidentally. However, HALT also may worsen in severity, resulting in leaflet immobility and/or valve deterioration. The clinical significance of HALT is a topic of ongoing debate, and currently there is no consensus on the screening and management of HALT in patients following TAVR or SAVR. This review provides a comprehensive evaluation of the available evidence on risk factors, preventative measures, treatment, and prognosis for this growing patient cohort.
近三分之一接受外科主动脉瓣置换术 (SAVR) 或经导管主动脉瓣置换术 (TAVR) 的患者在一年内会出现低衰减瓣叶增厚 (HALT)。HALT 通常代表无症状患者的亚临床瓣叶血栓形成,因此通常是偶然发现的。然而,HALT 的严重程度也可能恶化,导致瓣叶活动受限和/或瓣膜恶化。HALT 的临床意义是一个正在讨论的话题,目前对于 TAVR 或 SAVR 后患者的 HALT 筛查和管理尚无共识。本综述全面评估了该患者群体的危险因素、预防措施、治疗和预后的现有证据。