Sanal flow choking, a groundbreaking concept rooted in the fundamental principles of fluid dynamics and thermodynamics, redefines our understanding of cardiovascular physiology, particularly in the context of multi-phase flows and shock waves [1-15]. Contrary to critiques labeling it as a fallacy [16], this theory provides a crucial framework for addressing flow dynamics in extreme physiological conditions, such as decompression sickness and microgravity, where blood compressibility and gas evolution become prominent [3]. Our extensive research—spanning analytical [3-7], in silico [8-11], in vitro [8-10], and in vivo [1,2,15] studies—demonstrates that under certain pathological or environmental circumstances, blood exhibits compressible flow behavior, leading to multi-phase flow choking and subsequent shock wave formation [1,2]. This paradigm shift challenges the traditional assumption of blood as an incompressible fluid, which has limited the medical understanding of high-speed cardiovascular flow and trauma. Through the introduction of critical indices, such as the Lower Critical Hemorrhage Index (LCHI) and Upper Critical Hemorrhage Index (UCHI), Sanal flow choking offers a robust method to predict cardiovascular risks, including embolisms and vascular damage, induced by rapid pressure changes and gas bubble formation. Furthermore, these phenomena are influenced by the thermodynamic properties of blood and the coexistence of liquid and gas phases. In this rebuttal, we clarify the misinterpretations presented in a recent correspondence [16] against our articles [1-15] and reaffirm the validity of Sanal flow choking in cardiovascular research. We argue that compressible flow theory is indispensable for accurately modeling blood behavior in extreme conditions, and our findings underscore the necessity of revisiting long-held assumptions to prevent significant cardiovascular risks in both clinical and aerospace environments. It is clear that the correspondence [16] misinterprets our detailed analytical, in silico, in vitro, and animal in vivo research, as outlined in our review article in Physics of Fluids [1]. We wish to reaffirm that Sanal flow choking in cardiovascular systems is not a scientific fallacy, but a revolutionary concept grounded in established thermodynamic and fluid dynamics principles [3]. This concept challenges traditional views and provides new insights into the behavior of multiphase flows and shock waves in biological systems as detailed below.