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[Correspondence] Direct visualisation of thrombi for diagnosis of tissue valve thrombosis

Tarun Chakravarty and colleagues (June 17, 2017, p 2383)1 used restricted leaflet motion on CT as the principal surrogate measure to estimate the frequency of subclinical thrombosis after surgical and transcatheter aortic valve replacement. Although restricted leaflet motion (by fluoroscopy) is integral to the diagnosis of symptomatic mechanical heart valve thrombosis,2 it might be less sensitive than direct visualisation for the detection of tissue valve thrombosis, particularly in asymptomatic patients.