<p>This study employs computational fluid dynamics simulations to investigate the impact of different transcatheter aortic valve implantation (TAVI) positions on thrombosis risk, with a focus on the sinus and neosinus regions. Patient-specific models were developed using clinically obtained aortic geometries to analyze three distinct TAVI positions: intra-annular, supra-annular, and extreme supra-annular. These models were analyzed to assess flow characteristics, time-averaged wall shear stress (TAWSS), oscillatory shear index, and relative residence time. The results indicate that the intra-annular position exhibits stronger oscillations and higher blood stagnation, leading to an increased thrombosis risk, particularly in the neosinus region. In contrast, the supra-annular and extreme supra-annular positions showed similar flow patterns, with higher TAWSS observed in the extreme supra-annular configuration. This study provides insights into optimizing transcatheter heart valve designs and placement strategies to reduce thrombosis risk and improve patient outcomes in transcatheter valve procedures.</p> Graphical abstract <p></p>