Double-outlet right ventricle revisited

Ameneh Ebadi*, Diane E. Spicer, Carl L. Backer, F. Jay Fricker, Robert H. Anderson

*Corresponding author for this work

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Objectives Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation. Methods The hearts examined were from the University of Florida in Gainesville; Johns Hopkins All Children's Hospital, St Petersburg, Fla; and Lurie Children's Hospital, Chicago, Ill. Each specimen had at least 75% of both arterial roots supported by the morphologically right ventricle, with a total of 100 hearts examined. The morphologic method was used to assess anatomic features, including arterial-atrioventricular valvular continuity, subarterial infundibular musculature, and the location of the hole between the ventricles. Results Most hearts had fibrous continuity between one of the arterial valves and an atrioventricular valve, with bilateral infundibula in 23%, and intact ventricular septum in 5%. Conclusions Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum.

Original languageEnglish (US)
Pages (from-to)598-604
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume154
Issue number2
DOIs
StatePublished - Aug 2017

Keywords

  • double-outlet right ventricle
  • interventricular communication
  • malposition
  • ventricular septal defect

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Ebadi, A., Spicer, D. E., Backer, C. L., Fricker, F. J., & Anderson, R. H. (2017). Double-outlet right ventricle revisited. Journal of Thoracic and Cardiovascular Surgery, 154(2), 598-604. https://doi.org/10.1016/j.jtcvs.2017.03.049