Early hypoattenuated leaflet thickening and restricted leaflet motion of a Lotus transcatheter heart valve detected by 4D computed tomography angiography

An 85-year-old woman with severe aortic stenosis (AVA: 0.7 cm², mean gradient 56 mmHg) underwent transcatheter aortic valve implantation (TAVI) with a 25 mm Lotus™ transcatheter heart valve (Boston Scientific, Marlborough, MA, USA) via a femoral approach. Peri-interventionally, 600 mg clopidogrel, 400 mg aspirin and 5,000 IU heparin were administered. Post implantation the patient received dual antiplatelet therapy with aspirin 100 mg and clopidogrel 75 mg and heparin 7,500 IU bid.

To check the sizing and positioning of the valve, 4D computed tomography angiography (CTA) was carried out on day four which showed hypoattenuated thickening of the left prosthesis leaflet (Figure 1A-Figure 1C) and restricted leaflet motion (Figure 1...