Abstract
Objective: Aortic stenosis (AS) is a prevalent valve condition with poor outcomes when left untreated. AS severity metrics are discordant in 30% of cases rendering clinical decision-making complex. Superior imaging techniques for non-invasive pressure estimation are emerging but progress is limited by access to invasive haemodynamic data. Our aim was to develop and test a magnetic resonance (MRI)- and ultrasound (US)-compatible valve phantom which could approximate in vivo haemodynamics and yield a reproducible ground-truth pressure measurement. Methods: Silicone 0030 was injected into 3D-printed moulds to create an aortic valve model. The valve was affixed into a rigid ring mount and placed within a silicone “aorta” which was suspended in an acrylic box and submerged in 1% agar compound. Pressure sensors were embedded along the “aorta” wall. The complete phantom was connected to a MRI-compatible pump. Imaging was undertaken using both US and MRI. A protocol which involved recurrent data acquisition under both constant and pulsatile flow was repeated for several different scenarios of dismantling and reassembling the phantom to assess reproducibility. Results: Geometry and function captured by either MRI or US imaging were anatomically and physiologically adequate, with accurate pressure trace morphology. Under different flow conditions the peak instantaneous pressure drops were well correlated amongst repeated measurements across scenarios (Table). Conclusions: Here we report successful creation and testing of a MRI and US compatible valve phantom with compliant aorta model and direct pressure measurement which achieves consistency and reproducibility to underpin further research into imaging-based characterization of AS. Pressure drop correlation Condition Valve Purge and refill Dismantle and remove valve Change valve 1 2 3 4 1 A no no no / .993 .991 .934 2 A yes no no .993 / .998 .967 3 A yes yes no .991 .998 / .961 4 B yes yes yes .934 .967 .961 /
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