{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:28:19Z","timestamp":1786699699516,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Leaflet thrombosis after transcatheter aortic valve replacement (TAVR), typically identified as hypoattenuated leaflet thickening (HALT) on multidetector computed tomography (MDCT), is increasingly recognized as an early manifestation of bioprosthetic valve dysfunction. However, factors associated with early HALT in Southeast Asian populations remain poorly characterized. The objective of this study was to characterize MDCT features of leaflet thrombosis and identify factors independently associated with early HALT after TAVR. Methods: In this two-center observational study, patients undergoing MDCT 1\u20133 months after TAVR were evaluated. Leaflet thrombosis was defined as HALT. Leaflet involvement, thrombus severity, anatomical distribution, and post-implantation geometric parameters were analyzed. Multivariable logistic regression identified factors associated with early HALT. Results: Among 65 patients, HALT was detected in 30.8%, predominantly as subclinical leaflet thrombosis (29.2%), whereas clinical valve thrombosis was rare (1.5%). Most cases involved one or two leaflets, with preferential involvement of the non-coronary cusp. Patients with HALT showed greater increases in transvalvular peak gradients, and a peak gradient increase \u226510 mmHg was more frequent than in patients without HALT (30.0% vs. 4.4%; p = 0.008). Severe RCA ostial eccentricity (grade 3\u20134) combined with a neo-sinus\u2013RCA distance &gt; 13 mm was independently associated with HALT (adjusted OR 5.52; p = 0.006). Lack of left ventricular ejection fraction improvement after TAVR was also independently associated with HALT (adjusted OR 4.44; p = 0.018), though given the limited number of HALT events (n = 20), these multivariable associations should be regarded as exploratory and hypothesis-generating. Conclusions: Early post-TAVR leaflet thrombosis is common and predominantly subclinical. CT-derived neo-sinus geometry and impaired ventricular recovery were independently associated with HALT, supporting the hypothesis that altered neo-sinus washout contributes to thrombus formation.<\/jats:p>","DOI":"10.3390\/jcm15166219","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T10:32:16Z","timestamp":1786444336000},"page":"6219","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-TAVR Neo-Sinus Geometry and Impaired Ventricular Recovery Are Associated with Early Leaflet Thrombosis: First MDCT Insights from Vietnam"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4989-0299","authenticated-orcid":false,"given":"Phi","family":"Dinh Truong","sequence":"first","affiliation":[{"name":"Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11520, Vietnam"},{"name":"Department of Cardiology, Hanoi Medical University, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1742-3061","authenticated-orcid":false,"given":"Hoai","family":"Thi Thu Nguyen","sequence":"additional","affiliation":[{"name":"Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11520, Vietnam"},{"name":"Department of Internal Medicine, VNU University of Medicine and Pharmacy, Hanoi 11314, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quang","family":"Ngoc Nguyen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hanoi Medical University, Hanoi 11520, Vietnam"},{"name":"Vinmec Times City, Vinmec International Hospital, Hanoi 11622, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linh","family":"Huynh Dinh","sequence":"additional","affiliation":[{"name":"Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11520, Vietnam"},{"name":"Department of Cardiology, Hanoi Medical University, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyet","family":"Minh Thi Giap","sequence":"additional","affiliation":[{"name":"Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4298-2083","authenticated-orcid":false,"given":"Thai","family":"Quoc Nguyen","sequence":"additional","affiliation":[{"name":"Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh","family":"Nhat Pham","sequence":"additional","affiliation":[{"name":"Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11520, Vietnam"},{"name":"Department of Cardiology, Hanoi Medical University, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9288-041X","authenticated-orcid":false,"given":"Than Xuan","family":"Le","sequence":"additional","affiliation":[{"name":"Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11520, Vietnam"},{"name":"Vinmec Times City, Vinmec International Hospital, Hanoi 11622, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Phi Ngo","sequence":"additional","affiliation":[{"name":"Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5965-5381","authenticated-orcid":false,"given":"Trang","family":"Ngoc Nguyen","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Bach Mai Hospital, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hue","family":"Minh Thi Bui","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Hanoi Medical University, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh","family":"Van Nguyen","sequence":"additional","affiliation":[{"name":"Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7295-3041","authenticated-orcid":false,"given":"Olivier","family":"Morel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hanoi Medical University, Hanoi 11520, Vietnam"},{"name":"Department of Cardiology, University Hospital of Strasbourg, 67098 Strasbourg, France"},{"name":"Research Unit\u2014UR3074\u2014Translational Cardiovascular Medicine, University of Strasbourg, 67000 Strasbourg, France"},{"name":"GERCA (Groupe pour l\u2019Enseignement et la Recherche Cardiologique en Alsace), 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8943-3248","authenticated-orcid":false,"given":"Hung","family":"Manh Pham","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hanoi Medical University, Hanoi 11520, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102085","DOI":"10.1016\/j.jacadv.2025.102085","article-title":"Subclinical Leaflet Thrombosis and Subclinical Aortic Valve Complex Thrombosis in TAVR","volume":"4","author":"Marchandot","year":"2025","journal-title":"JACC Adv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e041505","DOI":"10.1161\/JAHA.125.041505","article-title":"Transcatheter Aortic Valve Durability: Focus on Structural Valve Deterioration","volume":"14","author":"Trimaille","year":"2025","journal-title":"J. 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