{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:56:54Z","timestamp":1790697414314,"version":"4.1.0"},"reference-count":21,"publisher":"IMR Press","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Beijing Hospitals Authority\u2019s Ascent Plan","award":["DFL20240604"],"award-info":[{"award-number":["DFL20240604"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background: Subclinical leaflet thrombosis (SLT) is associated with an increased risk of thromboembolic events, valve dysfunction, and mortality in patients undergoing transcatheter aortic valve replacement (TAVR). However, data on the incidence and risk factors for SLT in patients undergoing TAVR using self-expanding valves (SEVs) remain limited. Methods: This study included patients who underwent TAVR using SEVs and received a postoperative four-dimensional computed tomography scan within six months at Beijing Anzhen Hospital and Fuwai Hospital. SLT was defined as the presence of hypo-attenuated leaflet thickening (HALT) with or without reduced leaflet motion (RLM), and characterized by increased leaflet thickness affecting one or more leaflets. Univariate and multivariable logistic regression analyses were conducted to explore the relationship between variables and the occurrence of SLT. Results: A total of 311 patients (mean age 72.02 \u00b1 8.23 years, 52.4% males) were included in the analysis. HALT was detected in 91 patients (29.3%), while RLM was observed in 45 patients (14.5%). Most HALT (81.3%) and RLM (73.3%) cases were classified as grades 1\u20132. Multivariable logistic regression analysis revealed that using skirted prosthetic valves was significantly associated with SLT (adjusted odds ratio: 2.999; 95% confidence interval: 1.250\u20137.397; p = 0.015). Conclusions: Over one-quarter of patients undergoing TAVR using SEVs developed SLT within six months. The use of skirted prosthetic valves was independently associated with SLT.<\/jats:p>","DOI":"10.31083\/rcm49694","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:57:11Z","timestamp":1790693831000},"source":"Crossref","is-referenced-by-count":0,"title":["Skirted Prosthetic Valves Are Associated With Increased Risk of Subclinical Leaflet Thrombosis Following Transcatheter Aortic Valve Replacement: A Multicenter Study"],"prefix":"10.31083","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1154-9410","authenticated-orcid":true,"given":"Yifan","family":"Yang","sequence":"first","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4897-1012","authenticated-orcid":true,"given":"Qiang","family":"Li","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Yao","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfeng","family":"Yan","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moyang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinmin","family":"Liu","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Yuan","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengming","family":"Jiang","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiyang","family":"Luo","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 100037 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7868-6132","authenticated-orcid":true,"given":"Guangyuan","family":"Song","sequence":"additional","affiliation":[{"name":"Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Praz F, Borger MA, Lanz J, Marin-Cuartas M, Abreu A, Adamo M, et al. 2025 ESC\/EACTS Guidelines for the management of valvular heart disease. European Heart Journal. 2025; 46: 4635\u20134736.","DOI":"10.1093\/eurheartj\/ehaf194"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Blanke P, Leipsic JA, Popma JJ, Yakubov SJ, Deeb GM, Gada H, et al. Bioprosthetic Aortic Valve Leaflet Thickening in the Evolut Low Risk Sub-Study. Journal of the American College of Cardiology. 2020; 75: 2430\u20132442.","DOI":"10.1016\/j.jacc.2020.03.022"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Otsuka Y, Ishii M, Tabata N, Oda S, Kidoh M, Shirahama Y, et al. Subclinical leaflet thrombus in patients with severe aortic stenosis and atrial fibrillation -ENRICH-AF TAVI study. Scientific Reports. 2024; 14: 14902.","DOI":"10.1038\/s41598-024-65600-5"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Fukui M, Bapat VN, Garcia S, Dworak MW, Hashimoto G, Sato H, et al. Deformation of Transcatheter Aortic Valve Prostheses: Implications for Hypoattenuating Leaflet Thickening and Clinical Outcomes. Circulation. 2022; 146: 480\u2013493.","DOI":"10.1161\/CIRCULATIONAHA.121.058339"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Rashid HN, Gooley RP, Nerlekar N, Ihdayhid AR, McCormick LM, Nasis A, et al. Bioprosthetic aortic valve leaflet thrombosis detected by multidetector computed tomography is associated with adverse cerebrovascular events: a meta-analysis of observational studies. EuroIntervention. 2018; 13: e1748\u2013e1755.","DOI":"10.4244\/EIJ-D-17-01062"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Garcia S, Fukui M, Dworak MW, Okeson BK, Garberich R, Hashimoto G, et al. Clinical Impact of Hypoattenuating Leaflet Thickening After Transcatheter Aortic Valve Replacement. Circulation. Cardiovascular Interventions. 2022; 15: e011480.","DOI":"10.1161\/CIRCINTERVENTIONS.121.011480"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Chitturi KR, Aladin AI, Braun R, Al-Qaraghuli AK, Banerjee A, Reddy P, et al. Bioprosthetic Aortic Valve Thrombosis: Definitions, Clinical Impact, and Management: A State-of-the-Art Review. Circulation. Cardiovascular Interventions. 2024; 17: e014143.","DOI":"10.1161\/CIRCINTERVENTIONS.123.014143"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Koo HJ, Kang J, Kang DY, Ahn JM, Park DW, Park SJ, et al. Native Sinus Hemodynamics and Thrombosis in Transcatheter Heart Valve: Effect of Implant Depth and Coronary Flow. Journal of the American Heart Association. 2024; 13: e037105.","DOI":"10.1161\/JAHA.124.037105"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Midha PA, Raghav V, Condado JF, Okafor IU, Lerakis S, Thourani VH, et al. Valve Type, Size, and Deployment Location Affect Hemodynamics in an In Vitro Valve-in-Valve Model. JACC. Cardiovascular Interventions. 2016; 9: 1618\u20131628.","DOI":"10.1016\/j.jcin.2016.05.030"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Qiu D, Azadani AN. 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Standardized Definitions for Bioprosthetic Valve Dysfunction Following Aortic or Mitral Valve Replacement: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2022; 80: 545\u2013561.","DOI":"10.1016\/j.jacc.2022.06.002"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Blanke P, Weir-McCall JR, Achenbach S, Delgado V, Hausleiter J, Jilaihawi H, et al. Computed Tomography Imaging in the Context of Transcatheter Aortic Valve Implantation (TAVI)\/Transcatheter Aortic Valve Replacement (TAVR): An Expert Consensus Document of the Society of Cardiovascular Computed Tomography. JACC. Cardiovascular Imaging. 2019; 12: 1\u201324.","DOI":"10.1016\/j.jcmg.2018.12.003"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Rashid HN, Michail M, Ihdayhid AR, Khav N, Tan S, Nasis A, et al. Prosthesis Geometrical Predictors of Leaflet Thrombosis Following Transcatheter Aortic Valve Replacement With Intra-Annular Prostheses. 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