Heart, Lung and Circulation

Leaflet Immobility and Hypo-Attenuated Leaflet Thrombosis (HALT)–Under-Recognised Complications of Bioprosthetic Valve Replacements

      Bioprosthetic leaflet immobility is under-recognised and is highlighted by an article by Naser et al. [
      • Naser J.A.
      • Crestanello J.A.
      • Nkomo V.T.
      • Luis S.A.
      • Thaden J.T.
      • Geske J.B.
      • et al.
      Immobile leaflets at time of bioprosthetic valve implantation: A novel risk factor for early bioprosthetic failure.
      ] in this edition of Heart, Lung and Circulation. The authors assert in their conclusions that “Immobile leaflet immediately post-bioprosthetic valve implantation is frequently under-recognised intra-operatively and appears to be associated with early bioprosthetic dysfunction and worse clinical outcome”. The valves assessed were predominantly porcine and while the number of cases is small, there was not much detail on the overall percent incidence of this issue. However, the presence of early bioprosthetic valve regurgitation and leaflet hypomobility is something that most cardiac surgeons and cardiac anesthetists are aware of, even if reported findings are uncommon.


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