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February 13, 2026JACC Case Reports0 citationsOpen Access

Obstructive Hypoattenuated Leaflet Thickening in a Complex Valve-in-Valve TAVR Successfully Treated With Thrombolysis

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DSDhan Bahadur ShresthaACAshlesha ChaudharyUMUnaib Ahmed Memon

Key Result

Ultraslow, low-dose thrombolysis followed by anticoagulation safely restores valve function in obstructive hypoattenuated leaflet thickening when reoperation is prohibitive.

Key Points

  • The aim is to assess the effectiveness of thrombolysis for treatment of obstructive hypoattenuated leaflet thickening (HALT) in a valve-in-valve TAVR scenario.
  • Utilized ultraslow, low-dose thrombolysis as an intervention.
  • Followed thrombolysis with anticoagulation to restore valve function.
  • Evaluated patient outcomes post-treatment.
  • Thrombolysis successfully restored function in obstructive HALT cases.
  • Treatment was deemed safe without necessitating reoperation.

Structured PICO

Does ultraslow, low-dose thrombolysis followed by anticoagulation restore function in obstructive HALT after complex valve-in-valve TAVR?

P
Population
Patient with obstructive hypoattenuated leaflet thickening (HALT) in a complex valve-in-valve TAVR where reoperation is prohibitive
I
Intervention
Ultraslow, low-dose thrombolysis followed by anticoagulation
O
Outcome
Restoration of valve function

Ultraslow, low-dose thrombolysis followed by anticoagulation may be a safe and effective treatment for obstructive HALT in valve-in-valve TAVR when reoperation is prohibitive.

Abstract

Ultraslow, low-dose thrombolysis followed by anticoagulation can safely restore function in obstructive HALT when reoperation is prohibitive.

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Cite This Study

Shrestha et al. (2026) studied this question. Ultraslow, low-dose thrombolysis followed by anticoagulation safely restores valve function in obstructive hypoattenuated leaflet thickening when reoperation is prohibitive.

synapsesocial.com/papers/698ebf1d85a1ff6a93016577https://doi.org/10.1016/j.jaccas.2026.106960
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