ONE XI PULSE™ v6.0.0 — Cardiovascular, Structural Heart (TAVR/PCI) & Hemodynamic Digital Twin

FLAGSHIP CLINICAL DIGITAL TWINS:

MDCT Aortic Root & Patient Anatomy

Real-Time Inverse Compiler

Annulus Area 462 mm²

Annulus Perimeter 76.8 mm

Sinus of Valsalva Ø 31.2 mm

LCA Ostium Height 11.2 mm

RCA Ostium Height 13.8 mm

Leaflet Ca (HU850) 780 mm³

LVOT Ca Volume 42 mm³

Membranous Septum 3.6 mm

Pre-TAVR Peak Jet 4.62 m/s

Stroke Volume 68 mL

Valve Morphology

Patient BSA 1.84 m²

Inverse Compiler Optimal Prosthesis & Live Biomechanical Twin

OPTIMAL: NAVITOR_VISION_27

3-Radical Abjad Hemodynamic Manifold Transition (Pre → Post TAVR)

CRITICAL_CALCIFIC_STENOSIS → LAMINAR_COMPLIANT_EUHEMODYNAMIC

[غ-غ-غ] ← [ذ-ط-ح]

Selected Prosthesis

NAVITOR 27mm

Self-Expanding • Score 89.4

Mean Gradient (Pre→Post)

50.6 → 4.1

mmHg (Net Catheterization)

Post-Op EOA / iEOA

2.54 / 1.38

cm² | PPM: NONE

Coronary VTC (LCA/RCA)

5.57 / 6.62

mm (Safe Clearance ≥ 4mm)

PVL Regurgitant Frac

2.28%

Grade: NONE / TRACE

AORTIC ROOT, CORONARY VTC & DEPLOYED STENT FRAME

LEFT VENTRICULAR PRESSURE-VOLUME (P-V) LOOP (PRE vs POST TAVR)

Commercial Bioprosthesis Candidate Matrix (SAPIEN 3 Ultra RESILIA • Evolut FX+ • Navitor Vision)

Sorted by VARC-3 Biophysical Composite Optimality Score

Rank	Prosthesis ID	Platform Family	Oversizing %	Implant Depth	Post Mean PG	Post EOA / iEOA	PPM Risk	PVL Grade (RF%)	VTC LCA / RCA	Pacemaker Risk	VARC-3 Score

Doppler & Catheterization Inputs

Spectral Navier-Stokes + Casson

LVOT Diameter 19.0 mm

LVOT VTI 17.2 cm

AV Peak Velocity 3.68 m/s

AV VTI 86.5 cm

Ascending Aorta Ø 33.0 mm

Systolic BP 148 mmHg

Leaflet Ca (HU850) 685 mm³

Subvalvular LVOT PG 0 mmHg

Spectral Navier-Stokes Resolution & Pressure Recovery Deconvolution

STAGE_D1_D3_TRUE_SEVERE_AS

3-RADICAL ABJAD HEMODYNAMIC COORDINATE (r1: Inertial • r2: Casson WSS • r3: Windkessel Z_va)

PARADOXICAL_LOW_FLOW_HIGH_AFTERLOAD_STENOSIS

ش-ص-ظ

Continuity EOA / ELI

0.56 / 0.61

cm² | Energy Loss Index cm²/m²

1D Bernoulli vs Net Cath PG

34.8 vs 31.2

mmHg (Pressure Recovery: 4.1 mmHg)

Valvulo-Arterial Impedance

6.40

mmHg/mL/m² (SVi: 28.0 mL/m²)

Reynolds / Womersley α

8,920 / 21.4

Peak WSS: 38.4 Pa | OSI: 0.19

ONE XI PULSE Severity Score

78.4 / 100

Bayesian P(Severe) = 0.957

Epicardial & Microvascular Anatomy

Poiseuille + Borda-Carnot Solver

Target Vessel

Ref Vessel Diameter 3.40 mm

Lesion 1 Stenosis % 58%

Lesion 1 Length 16 mm

Lesion 2 Stenosis % 62%

Lesion 2 Length 21 mm

Microvascular IMR 16.5

Mean Aortic Pa 94 mmHg

Deterministic Hyperemic FFR, Wave-Free iFR & Virtual PCI Stent Pullback

PCI_OR_CABG_INDICATED (FFR ≤ 0.80)

Hyperemic FFR (Pd/Pa)

0.712

Ischemic Threshold ≤ 0.80

Resting Wave-Free iFR

0.841

Threshold ≤ 0.89

Virtual PCI Post-Stent FFR

0.884

Predicted Gain: +0.172 FFR

Trans-Stenotic ΔP

27.1 mmHg

CFR: 2.18 | Pd: 66.9 mmHg

PRESSURE-WIRE PULLBACK CURVE (0–100 mm FROM CORONARY OSTIUM: BASELINE RED vs VIRTUAL PCI EMERALD)

180-Case Synthetic Hemodynamic & Structural Heart Benchmark Verification

Cohort Source: Synthetic 180-case cohort (100 valvular AS + 80 coronary FFR) calibrated to published PARTNER-3 / Evolut Low-Risk / FAME-2 distributions

Pan-Cardiovascular AUROC (n=180)

0.9838

vs 0.7636 Standard 1D Baseline (+0.2202)

Structural Heart TAVR AUROC (n=100)

0.9898

vs 0.7806 1D Simplified Bernoulli

Catheterization Gradient MAE

0.981 mmHg

vs 8.144 mmHg 1D Simplified Bernoulli

Coronary Invasive FFR AUROC (n=80)

0.9744

vs 0.7192 1D QCA Diameter Stenosis (MAE 0.0121)

Cohort Subgroup	Sample Size	Clinical Challenge Addressed	1D Baseline Performance	ONE XI PULSE™ v6.0.0 Digital Twin	Status
Classical High-Gradient Severe AS	n = 25	High-velocity calcific stenosis & TAVR prosthesis sizing	Concordant	100% Sensitivity (MAE 0.91 mmHg)	VERIFIED
Paradoxical Low-Flow Low-Gradient AS	n = 15	SVi < 35 mL/m², LVEF ≥ 50%, 1D Mean PG 28–37 mmHg (Masked Severe AS)	Missed by 1D PG ≥ 40 cutoff	Rescued via ELI + Z_va + HU850 Ca	VERIFIED
Small Aorta Pressure-Recovery AS	n = 15	Ascending Aorta < 27 mm where 1D Doppler overestimates invasive Cath PG	False Positive Severe AS	Abbas-Garcia Momentum Corrected	VERIFIED
Intermediate Serial & Bifurcation FFR	n = 22	54–65% DS tandem lesions causing true functional ischemia (FFR ≤ 0.80)	Missed by 1D QCA ≥ 70% DS	Coupled Poiseuille + Carina Expansion	VERIFIED
Focal Small-Bed Discordant Coronary Stenosis	n = 20	63–70% focal short lesion in small territory with non-ischemic FFR > 0.80	False Positive Stenting	Territory-Mass & Length Corrected	VERIFIED