Key result
CFD-guided 3D templates enable DORV baffle repair with ~2 mmHg peak gradient.
Why the study?
Creating a baffle with adequate cross-sectional area that avoids the tricuspid valve apparatus during complex DORV repair is challenging in a distorted, arrested heart, and analytic approaches including CFD simulation have not yet been incorporated into clinical workflows.
Can preoperative computational fluid dynamic (CFD) simulation and 3D-printed template generation accurately guide intraoperative baffle construction to achieve acceptable outflow tract gradients in complex biventricular repair for DORV?
Case Report (n=1)
No
Can preoperative computational fluid dynamic (CFD) simulation and 3D-printed template generation accurately guide intraoperative baffle construction to achieve acceptable outflow tract gradients in complex biventricular repair for DORV?
First clinical report demonstrating that prospective CFD simulation and a 3D-printed template can directly guide off-pump pericardial baffle trimming for complex DORV biventricular repair, achieving high anatomical accuracy and a low postoperative outflow gradient.
Answers are grounded in this paper and cite their sources.
Supports CFD-guided 3D planning feasibility in complex DORV; leaves open prospective validation before clinical adoption.
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.
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Reed et al. (2026) conducted a case report in Double-outlet right ventricle (DORV) with subpulmonic ventricular septal defect (VSD) (n=1). Preoperative computational fluid dynamic (CFD) simulation-guided 3D-printed baffle template for biventricular repair was evaluated on Postoperative peak baffle pressure gradient and template-to-implant positional concordance. Preoperative CFD-guided 3D template construction yielded an implanted DORV repair baffle with a 2 mmHg peak gradient and a 1.05±0.89 mm positional discrepancy from the planned model.
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