Patient-specific computational modeling has emerged as a powerful tool for surgical planning in complex congenital heart disease. One promising application is complex biventricular repair, which often requires construction of a custom intraventricular baffle to establish a physiologic left ventricle-to-aorta outflow pathway. In current practice, baffle geometry is designed and shaped intraoperatively and preoperative planning remains largely manual, limiting the ability to generate anatomically conformal, watertight models suitable for quantitative hemodynamic assessment. In this work, we present a semi-automated computational framework for the design and assessment of patient-specific intraventricular baffles. The method constructs an explicit VSD-to-aorta flow pathway, preserves native right ventricular geometry, and reshapes only the baffle region using section-wise area constraints along a physiologically aligned centerline. The resulting geometry is integrated into a closed, multi-labeled domain for computational fluid dynamics analysis. We retrospectively applied this framework to four patients with double outlet right ventricle (DORV) who previously underwent biventricular repair. For each case, a patient-specific baffle was generated and its hemodynamic performance was evaluated using CFD. Predicted pressure gradients across the reconstructed outflow were within clinically acceptable ranges and comparable to the patients' postoperative echocardiographs. This approach enables quantitative, pre-operative design and evaluation of candidate baffle geometries and provides a reproducible method for generating simulation-ready models. By combining physiologically constrained geometric design with CFD-based assessment, the framework represents a step toward computational, patient-specific decision support for biventricular flow restoration in a complex heterogeneous patient population.

翻译：患者特异性计算建模已成为复杂先天性心脏病手术规划的有力工具。其重要应用之一在于复杂双心室修复术，该类手术通常需要构建定制化的心室内补片，以建立生理性的左心室至主动脉流出通道。当前临床实践中，补片几何形态在术中设计塑形，而术前规划仍高度依赖人工操作，难以生成符合解剖形态且具有水密性的模型用于定量血流动力学评估。本研究提出了一种半自动化计算框架，用于患者特异性心室内补片的设计与评估。该方法构建了清晰的室间隔缺损至主动脉血流通道，保留原生右心室几何结构，并仅对补片区域进行重塑，通过沿生理对齐中心线的截面面积约束进行调控。所得几何结构被整合至封闭的多标记域中，用于计算流体动力学分析。我们回顾性地将本框架应用于四例既往接受双心室修复术的右心室双出口（DORV）患者。每例均生成患者特异性补片，并通过CFD评估其血流动力学性能。结果显示，重建流出道上的预测压差处于临床可接受范围，且与患者术后超声心动图结果具有可比性。该方法实现了对候选补片几何形态的定量化术前设计与评估，并提供了可重复的仿真就绪模型生成方案。通过将生理约束几何设计与基于CFD的评估相结合，本框架为复杂异质性患者群体的双心室血流重建提供了向计算引导的个体化决策支持的重要一步。