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Verification of a Fluid-Structure Interaction Model for Aortic Stenosis Through Comparison With In Vitro Experiments

Verstraeten S, Meiburg R, Janssens K, Hoeijmakers M, Karajan N, Rutten M, Veer MV, Tonino P et al.

International journal for numerical methods in biomedical engineering, 2026

Abstract

Aortic stenosis (AS) severity is typically assessed by measuring pressure drop across the aortic valve in rest. However, this flow-dependent metric is influenced by patients' cardiac function, complicating clinical decision-making on valve replacement. Moreover, assessment during rest does not reflect valvular dynamics under higher flow rates (e.g., during exercise), and may underestimate severity in moderate AS patients. Patient-specific Fluid-Structure Interaction (FSI) modelling offers a promising, non-invasive method to simulate valve dynamics under varying conditions, independent of pressure exerted by the left ventricle. Therefore, this study aimed to experimentally verify an aortic stenosis FSI model using a patient-specific aortic valve geometry, including calcifications, across flow conditions ranging from rest to exercise. To achieve this goal, in vitro experiments were conducted using a mock-loop circulatory system with patient-specific silicone rubber valve models, both calcified and non-calcified. These experiments were replicated in FSI simulations. Overall, good agreement was observed between simulated and experimental results for the non-calcified valve in terms of mean transvalvular flow (5% error on average) and aortic valve area (AVA) (10% error on average). Discrepancies were more pronounced in the calcified valve due to added complexity and uncertainty introduced by calcifications (8% and 7% error on average for mean transvalvular flow and AVA,…

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