From Simulation to Suture Lines: Computational Fluid Dynamic Simulation-Guided Baffle Construction for Complex Biventricular Repair

Biventricular repair is favored for children with complex double-outlet right ventricle (DORV) to eliminate the long-term morbidity of single ventricle physiology. However, creating a baffle that maintains adequate cross-sectional area while limiting incursion on the tricuspid valve apparatus is challenging in a distorted, arrested heart. Three-dimensional (3D) models have aided baffle design with anatomic visualization but analytic approaches, including computational fluid dynamic (CFD) simulation support, have not yet been incorporated into clinical workflows. We present the preoperative, prospective construction of a DORV repair baffle guided by a semi-automated area-preserving algorithm and CFD analysis.