{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T16:41:45Z","timestamp":1788799305985,"version":"build-2803163510"},"reference-count":55,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Federal Ministry of Education and Research (BMBF)","award":["031A427A"],"award-info":[{"award-number":["031A427A"]}]},{"name":"ERA-CVD (SICVALVES)","award":["031A427A"],"award-info":[{"award-number":["031A427A"]}]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin and the Berlin Institute of Health","award":["031A427A"],"award-info":[{"award-number":["031A427A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Background: Recent studies suggest that any degree of patient-prosthesis mismatch (PPM) increases morbidity and mortality after surgical aortic valve replacement (SAVR). We used computational fluid dynamics simulations to test the influence of prosthesis size and physical activity after SAVR. Methods: In 10 patients with aortic valve stenosis, virtual SAVR was performed. Left ventricular outflow tract stroke volume and flow direction information (4D Flow) were used, and an increase in stroke volume of 25% was chosen for simulating physical activity. Pressure gradients (DP max) across the aortic valve and blood flow profiles in the ascending aorta were calculated and predicted for three different valve sizes at rest and under stress in every patient. Results: Gradients across the aortic valve were significantly lower using larger valves; however, they were not normalized after SAVR (DP max [mmHg] norm\/smaller\/reference\/larger valve = 6\/14\/12\/9 mmHg, &lt;0.01 compared to norm). Physical activity simulation increased DP max in all patients and across all valve sizes (DP max [mmHg] rest versus stress for the smaller\/reference\/larger valve = 14 vs. 23, 12 vs. 18, 9 vs. 14). Blood flow profiles did not normalize after SAVR and remained unaffected by physical activity. Gradients differed between mild and moderate stenosis between different therapy options and even showed moderate to severe stenosis under simulated physical activity. Conclusions: Prosthesis size and physical activity simulation have a significant influence on gradients across the aortic valve. Virtual therapy planning using patient-specific data might help to improve outcomes after SAVR in the future.<\/jats:p>","DOI":"10.3390\/bioengineering12040328","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T07:46:50Z","timestamp":1742802410000},"page":"328","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Virtual Therapy Planning of Aortic Valve Replacement for Preventing Patient-Prosthesis Mismatch"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4860-8010","authenticated-orcid":false,"given":"Marie","family":"Schafstedde","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Disease\u2014Pediatric Cardiology, German Heart Center Charit\u00e9, 13353 Berlin, Germany"},{"name":"Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany"},{"name":"Berlin Institute of Health (BIH), 10178 Berlin, Germany"},{"name":"Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, German Centre for Cardiovascular Research, Partner Site Berlin, 10785 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6573-1347","authenticated-orcid":false,"given":"Florian","family":"Hellmeier","sequence":"additional","affiliation":[{"name":"Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Gr\u00fcnert","sequence":"additional","affiliation":[{"name":"Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Materne","sequence":"additional","affiliation":[{"name":"Institute of Biometry and Statistical Epidemiology, Charit\u00e9 Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Titus","family":"Kuehne","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease\u2014Pediatric Cardiology, German Heart Center Charit\u00e9, 13353 Berlin, Germany"},{"name":"Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany"},{"name":"Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, German Centre for Cardiovascular Research, Partner Site Berlin, 10785 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1961-3179","authenticated-orcid":false,"given":"Leonid","family":"Goubergrits","sequence":"additional","affiliation":[{"name":"Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany"},{"name":"Einstein Center Digital Future, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Nordmeyer","sequence":"additional","affiliation":[{"name":"Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany"},{"name":"Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, German Centre for Cardiovascular Research, Partner Site Berlin, 10785 Berlin, Germany"},{"name":"Division of Pediatric Radiology, Department of Radiology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"s28","DOI":"10.1136\/heartjnl-2018-313515","article-title":"Patient-prosthesis mismatch following aortic valve replacement","volume":"105","author":"Bilkhu","year":"2019","journal-title":"Heart"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e005850","DOI":"10.1161\/JAHA.117.005850","article-title":"Impact of Mean Transaortic Pressure Gradient on Long-Term Outcome in Patients with Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction","volume":"6","author":"Bohbot","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/ejcts\/ezt245","article-title":"Indexed effective orifice area is a significant predictor of higher mid- and long-term mortality rates following aortic valve replacement in patients with prosthesis-patient mismatch","volume":"45","author":"Chen","year":"2014","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1136\/hrt.2005.067363","article-title":"Prosthesis-patient mismatch: Definition, clinical impact, and prevention","volume":"92","author":"Pibarot","year":"2006","journal-title":"Heart"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1016\/S0735-1097(00)00859-7","article-title":"Hemodynamic and clinical impact of prosthesis-patient mismatch in the aortic valve position and its prevention","volume":"36","author":"Pibarot","year":"2000","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1161\/01.CIR.0000085167.67105.32","article-title":"Impact of valve prosthesis-patient mismatch on short-term mortality after aortic valve replacement","volume":"108","author":"Blais","year":"2003","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Springhetti, P., Abdoun, K., Dumont, \u00c9., Dagenais, F., Kalavrouziotis, D., Mohammadi, S., Pibarot, P., and Clavel, M.A. (2025). Sex-related differences in prosthesis-patient mismatch after surgical aortic valve replacement and long-term outcomes. Eur. Heart J., ehaf076.","DOI":"10.1093\/eurheartj\/ehaf076"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.athoracsur.2018.01.090","article-title":"The Incidence and Consequence of Prosthesis-Patient Mismatch After Surgical Aortic Valve Replacement","volume":"106","author":"Fallon","year":"2018","journal-title":"Ann. Thorac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e033176","DOI":"10.1161\/JAHA.123.033176","article-title":"Impact of Prosthesis-Patient Mismatch After Surgical Aortic Valve Replacement: Systematic Review and Meta-Analysis of Reconstructed Time-to-Event Data of 122,989 Patients with 592,952 Patient-Years","volume":"13","author":"Jacquemyn","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.jcmg.2015.10.026","article-title":"Predictors and Outcomes of Prosthesis-Patient Mismatch After Aortic Valve Replacement","volume":"9","author":"Dayan","year":"2016","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1097\/RLI.0000000000000064","article-title":"Systolic flow displacement correlates with future ascending aortic growth in patients with bicuspid aortic valves undergoing magnetic resonance surveillance","volume":"49","author":"Burris","year":"2014","journal-title":"Investig. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1002\/jmri.24362","article-title":"MRI hemodynamic markers of progressive bicuspid aortic valve-related aortic disease","volume":"40","author":"Hope","year":"2014","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1002\/jmri.21082","article-title":"Comparison of flow patterns in ascending aortic aneurysms and volunteers using four-dimensional magnetic resonance velocity mapping","volume":"26","author":"Hope","year":"2007","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1007\/s10237-015-0729-2","article-title":"Multi-modality image-based computational analysis of haemodynamics in aortic dissection","volume":"15","author":"Noorani","year":"2016","journal-title":"Biomech. Model. Mechanobiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/j.ejvs.2016.07.025","article-title":"Computational Study of Anatomical Risk Factors in Idealized Models of Type B Aortic Dissection","volume":"52","author":"Figueroa","year":"2016","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1093\/ejcts\/ezz149","article-title":"Abnormal aortic flow profiles persist after aortic valve replacement in the majority of patients with aortic valve disease: How model-based personalized therapy planning could improve results. A pilot study approach","volume":"57","author":"Nordmeyer","year":"2020","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12968-020-00686-0","article-title":"Circulatory efficiency in patients with severe aortic valve stenosis before and after aortic valve replacement","volume":"23","author":"Nordmeyer","year":"2021","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1053\/j.semtcvs.2020.06.046","article-title":"Impact of Aortic Annulus Enlargement on the Outcomes of Aortic Valve Replacement: A Meta-analysis","volume":"33","author":"Zhigalov","year":"2021","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1136\/hrt.2006.102764","article-title":"Prediction of valve prosthesis-patient mismatch prior to aortic valve replacement: Which is the best method?","volume":"93","author":"Bleiziffer","year":"2007","journal-title":"Heart"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/j.jtcvs.2019.04.001","article-title":"Characteristics of surgical prosthetic heart valves and problems around labeling: A document from the European Association for Cardio-Thoracic Surgery (EACTS)-The Society of Thoracic Surgeons (STS)-American Association for Thoracic Surgery (AATS) Valve Labelling Task Force","volume":"158","author":"Durko","year":"2019","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Huang, X., Zhang, G., Zhou, X., and Yang, X. (2023). A review of numerical simulation in transcatheter aortic valve replacement decision optimization. Clin. Biomech., 106.","DOI":"10.1016\/j.clinbiomech.2023.106003"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2324","DOI":"10.1016\/j.bpj.2019.07.025","article-title":"Surgical Aortic Valve Replacement: Are We Able to Improve Hemodynamic Outcome?","volume":"117","author":"Yevtushenko","year":"2019","journal-title":"Biophys. J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Kelm, M., Goubergrits, L., Bruening, J., Yevtushenko, P., Fernandes, J.F., S\u00fcndermann, S.H., Berger, F., Falk, V., Kuehne, T., and Nordmeyer, S. (2017). Model-Based Therapy Planning Allows Prediction of Haemodynamic Outcome after Aortic Valve Replacement. Sci. Rep., 7.","DOI":"10.1038\/s41598-017-03693-x"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s12968-016-0252-3","article-title":"Age dependence of pulmonary artery blood flow measured by 4D flow cardiovascular magnetic resonance: Results of a population-based study","volume":"18","author":"Wehrum","year":"2016","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s12968-018-0461-z","article-title":"Determination of aortic stiffness using 4D flow cardiovascular magnetic resonance\u2014A population-based study","volume":"20","author":"Harloff","year":"2018","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"5172","DOI":"10.1007\/s00330-019-06104-z","article-title":"Retrograde aortic blood flow as a mechanism of stroke: MR evaluation of the prevalence in a population-based study","volume":"29","author":"Harloff","year":"2019","journal-title":"Eur. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"035003","DOI":"10.1088\/1361-6579\/acb8fd","article-title":"Population-based reference values for 4D flow MRI derived aortic blood flow parameters","volume":"44","author":"Schafstedde","year":"2023","journal-title":"Physiol. Meas."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Hellmeier, F., Br\u00fcning, J., S\u00fcndermann, S., Jarmatz, L., Schafstedde, M., Goubergrits, L., K\u00fchne, T., and Nordmeyer, S. (2020). Hemodynamic Modeling of Biological Aortic Valve Replacement Using Preoperative Data Only. Front. Cardiovasc. Med., 7.","DOI":"10.3389\/fcvm.2020.593709"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Franke, B., Br\u00fcning, J., Yevtushenko, P., Dreger, H., Brand, A., Juri, B., Unbehaun, A., Kempfert, J., S\u00fcndermann, S., and Lembcke, A. (2021). Computed Tomography-Based Assessment of Transvalvular Pressure Gradient in Aortic Stenosis. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.706628"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Yevtushenko, P., Goubergrits, L., Franke, B., Kuehne, T., and Schafstedde, M. (2023). Modelling blood flow in patients with heart valve disease using deep learning: A computationally efficient method to expand diagnostic capabilities in clinical routine. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1136935"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/0735-1097(92)90373-U","article-title":"Physiologic changes with maximal exercise in asymptomatic valvular aortic stenosis assessed by Doppler echocardiography","volume":"20","author":"Otto","year":"1992","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.jcmg.2016.03.018","article-title":"The Functional Significance of Paradoxical Low-Gradient Aortic Valve Stenosis: Hemodynamic Findings During Cardiopulmonary Exercise Testing","volume":"10","author":"Yotti","year":"2017","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1002\/jmri.22800","article-title":"Comparison of four-dimensional flow parameters for quantification of flow eccentricity in the ascending aorta","volume":"34","author":"Sigovan","year":"2011","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1002\/jmri.24498","article-title":"From unicuspid to quadricuspid: Influence of aortic valve morphology on aortic three-dimensional hemodynamics","volume":"40","author":"Entezari","year":"2014","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1161\/CIRCULATIONAHA.113.003026","article-title":"Bicuspid aortic cusp fusion morphology alters aortic three-dimensional outflow patterns, wall shear stress, and expression of aortopathy","volume":"129","author":"Mahadevia","year":"2014","journal-title":"Circulation"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1093\/eurheartj\/ehac803","article-title":"ESC\/EACTS vs. ACC\/AHA guidelines for the management of severe aortic stenosis","volume":"44","author":"Lee","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1136\/hrt.2004.044099","article-title":"Valve replacement in patients with critical aortic stenosis and depressed left ventricular function: Predictors of operative risk, left ventricular function recovery, and long term outcome","volume":"91","author":"Vaquette","year":"2005","journal-title":"Heart"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.jcin.2012.02.010","article-title":"Predictive factors, efficacy, and safety of balloon post-dilation after transcatheter aortic valve implantation with a balloon-expandable valve","volume":"5","author":"Larose","year":"2012","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/j.jcin.2014.02.013","article-title":"Outcomes with post-dilation following transcatheter aortic valve replacement: The PARTNER I trial (placement of aortic transcatheter valve)","volume":"7","author":"Hahn","year":"2014","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jcmg.2018.10.020","article-title":"Imaging for Predicting and Assessing Prosthesis-Patient Mismatch After Aortic Valve Replacement","volume":"12","author":"Pibarot","year":"2019","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1111\/echo.13735","article-title":"Hemodynamic assessment of Perceval sutureless bioprosthesis by dobutamine stress echocardiography","volume":"35","author":"Rubino","year":"2018","journal-title":"Echocardiography"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1111\/jocs.16220","article-title":"Stress exercise haemodynamic performance and opening reserve of a stented bovine pericardial aortic valve bioprosthesis","volume":"37","author":"Porterie","year":"2022","journal-title":"J. Card. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1093\/icvts\/ivu446","article-title":"Four-dimensional magnetic resonance imaging-derived ascending aortic flow eccentricity and flow compression are linked to aneurysm morphology","volume":"20","author":"Kari","year":"2015","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/j.jacc.2015.06.1310","article-title":"Valve-Related Hemodynamics Mediate Human Bicuspid Aortopathy: Insights From Wall Shear Stress Mapping","volume":"66","author":"Guzzardi","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12968-020-00703-2","article-title":"Fully quantitative mapping of abnormal aortic velocity and wall shear stress direction in patients with bicuspid aortic valves and repaired coarctation using 4D flow cardiovascular magnetic resonance","volume":"23","author":"Farag","year":"2021","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_46","first-page":"e004038","article-title":"Evaluation of Aortic Blood Flow and Wall Shear Stress in Aortic Stenosis and Its Association With Left Ventricular Remodeling","volume":"9","author":"Karunaharamoorthy","year":"2016","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"An, K., Zhang, F., Ouyang, W., and Pan, X. (2024). Blood flow dynamics in the ascending aorta of patients with bicuspid aortic valve before and after transcatheter aortic valve replacement: A computational fluid dynamics study. BMC Cardiovasc. Disord., 24.","DOI":"10.1186\/s12872-024-04394-w"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Khodaei, S., Henstock, A., Sadeghi, R., Sellers, S., Blanke, P., Leipsic, J., Emadi, A., and Keshavarz-Motamed, Z. (2021). Personalized intervention cardiology with transcatheter aortic valve replacement made possible with a non-invasive monitoring and diagnostic framework. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-85500-2"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1136\/heartjnl-2015-308044","article-title":"Computational fluid dynamics modelling in cardiovascular medicine","volume":"102","author":"Morris","year":"2016","journal-title":"Heart"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s11517-024-03215-8","article-title":"Generation of a virtual cohort of TAVI patients for in silico trials: A statistical shape and machine learning analysis","volume":"63","author":"Scuoppo","year":"2025","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"101482","DOI":"10.1016\/j.cpcardiol.2022.101482","article-title":"Machine Learning Approach on High Risk Treadmill Exercise Test to Predict Obstructive Coronary Artery Disease by using P, QRS, and T waves\u2019 Features","volume":"48","author":"Yilmaz","year":"2023","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Cicek, V., Orhan, A.L., Saylik, F., Sharma, V., Tur, Y., Erdem, A., Babaoglu, M., Ayten, O., Taslicukur, S., and Oz, A. (2024). Predicting Short-Term Mortality in Patients With Acute Pulmonary Embolism with Deep Learning. Circ. J.","DOI":"10.1253\/circj.CJ-24-0630"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.pcad.2021.11.003","article-title":"Transcatheter aortic valve replacement (TAVR): Recent updates","volume":"69","author":"Avvedimento","year":"2021","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.amjcard.2019.10.057","article-title":"Meta-Analysis Comparing Results of Transcatheter Versus Surgical Aortic-Valve Replacement in Patients With Severe Aortic Stenosis","volume":"125","author":"Zhang","year":"2020","journal-title":"Am. J. Cardiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1056\/NEJMoa1008232","article-title":"Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery","volume":"363","author":"Leon","year":"2010","journal-title":"N. Engl. J. Med."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/4\/328\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:58:13Z","timestamp":1760029093000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/4\/328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,21]]},"references-count":55,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["bioengineering12040328"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering12040328","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,21]]}}}