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Neosinus and Valve Thrombosis After Transcatheter Aortic Valve Replacement
Nan Chen1, Yu Mao2,3, Hui-Ping Zhang1
1Department of Cardiology, Beijing Hospital, National Center of Gerontology Institute of Geriatric Medicine, Chinese Academy of Medical Sciences Beijing China.
Journal of the American Heart Association
|April 20, 2026
Summary
Transcatheter aortic valve replacement (TAVR) can lead to leaflet thrombosis due to neosinus formation. Local hemodynamics within the neosinus is a key factor influencing this TAVR complication.
Area of Science:
- Cardiovascular Medicine
- Medical Devices
- Biomedical Engineering
Background:
- Transcatheter aortic valve replacement (TAVR) is a primary treatment for aortic stenosis, now used in low-risk patients.
- Leaflet thrombosis is a significant complication of TAVR, leading to valve dysfunction.
- Neosinus formation and altered hemodynamics post-TAVR are implicated in leaflet thrombosis.
Purpose of the Study:
- To systematically review neosinus thrombosis after TAVR.
- To summarize incidence, anatomical/pathological remodeling, mechanisms, and hemodynamic factors of neosinus thrombosis.
- To highlight local hemodynamics as a critical, modifiable factor.
Main Methods:
- Systematic literature review.
- Integration of evidence on neosinus formation and its link to TAVR leaflet thrombosis.
- Analysis of anatomical, pathological, and hemodynamic data.
Main Results:
- Neosinus formation post-TAVR is closely linked to leaflet thrombosis.
- Local hemodynamic changes within the neosinus are a dominant factor in thrombosis development.
- Evidence on incidence, remodeling, and mechanisms is synthesized.
Conclusions:
- Local hemodynamics within the neosinus is the primary modifiable factor in TAVR leaflet thrombosis.
- Future research should focus on patient-specific modeling and long-term outcomes.
- Optimizing TAVR design and surgical strategies is crucial for mitigating thrombosis.
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