Anomalous Origin of Right Pulmonary Artery from Ascending Aorta: Pre- and Postoperative Noninvasive Hemodynamic Evaluation.

This report describes the innovative use of computational fluid dynamics (CFD) in managing a case in a 17-year-old male patient with anomalous origin of the right pulmonary artery from the ascending aorta, presenting with hemoptysis. Given the high risk of late repair, patient-specific CFD models were created. Preoperative simulation replicated invasive pressure measurements, and a virtual surgery predicted favorable outcomes. The patient underwent successful surgical reimplantation. Postoperatively, CFD findings at 1 week and 4 months closely matched the virtual prediction and were validated by synchronous four-dimensional flow MRI, demonstrating progressive hemodynamic normalization. Our experience suggests that CFD is a valuable adjunct for surgical planning and longitudinal assessment in complex congenital heart disease. Keywords: Congenital, Cardiac, CT-Angiography, Hemodynamics/Flow Dynamics, MR-Imaging, Pulmonary Arteries, Aorta Supplemental material is available for this article. ©The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license.