Abstract
A 78-year-old female developed symptomatic bioprosthetic valve thrombosis 32 months post-transapical TAVI, despite 6-month warfarin therapy. Echocardiography showed severe hemodynamic compromise with left ventricular remodeling and diastolic dysfunction. CT-confirmed thrombosis resolved after warfarin intensification and cardiac optimization, achieving mean gradient reduction to 17 mmHg within 8 weeks. This highlights the association between delayed thrombosis, ventricular remodeling, and subtherapeutic anticoagulation.