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Double outlet right ventricle—an echocardiographic study

Published online by Cambridge University Press:  19 August 2008

Oscar Arista-Salado Martínez ,
José Arango Casado ,
María V. de la Cruz ,
Francisco Díaz  and
Osiris Cubero
Oscar Arista-Salado Martínez
Affiliation:
From the Cardiocentro del Hospital William Soler, Habana
José Arango Casado
Affiliation:
From the Cardiocentro del Hospital William Soler, Habana
María V. de la Cruz*
Affiliation:
The Hospital Infantil de México“Federico Gómez”, México City
Francisco Díaz
Affiliation:
From the Cardiocentro del Hospital William Soler, Habana
Osiris Cubero
Affiliation:
From the Cardiocentro del Hospital William Soler, Habana
*
Correspondence to Dr. María V. de la Cruz, Departamento de Biología del Desarrollo y Teratogénesis Experimental, Hospital Infantil de México“Federico Gómez”, Dr. Márquez No. 162, Col. Doctores, Deleg. Cuauhtémoc, C.P. 06720, México D.F., México.
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Summary

We examined the echocardiograms of 40 patients with double oudet right ventricle, proven either at autopsy or during surgery. By way of the subcostal approach, it proved possible to determine the insertion of the outlet (infundibular) septum and to categorize the malformations within the classification proposed by de la Cruz and her colleagues. It was also possible to ascertain the relationships of the atrioventricular valves with one or with both infundibulums, and these features could be correlated with infundibular interrelationships. The interrelationship of the great arteries, in contrast, was not always in accordance with the infundibular interrelationships, indicating that the arterial interrelationship may not prove to be a good parameter for surgical decision-making. Of greatest importance was the visualization and echocardiographic appraisal of the spatial position and size of the ventriculoinfundibular fold, since this anatomic feature was the key to determining the optimal surgical approach. This is so because the ventriculoinfundibular fold constitutes one of the borders of the ventricular septal defect, and separates it from the plane of the leaflets of the arterial valves. Furthermore, the fold frequendy contributes to infundibular obstruction. Our echocardiographic studies, based on a better anatomic knowledge, permitted us to choose the most suitable surgical technique in our patients.

Keywords

Double outlet right ventricleechocardiographyoutlet septuminfundibular interrelationshipventriculoinfundibular fold
Type
Original Articles
Information
Cardiology in the Young , Volume 3 , Issue 2 , April 1993 , pp. 124 - 131
Copyright
Copyright © Cambridge University Press 1993

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References

1.Neufeld, HN, Dushane, JW, Wood, EH, Kirklin, JW, Edwards, JE. Origin of both great vessels from the right ventricle. Without pulmonary stenosis. Circulation 1961; 23: 399–412.CrossRefGoogle ScholarPubMed
2.Lev, M, Bharati, S, Meng, CCL, Liberthson, RR, Paul, MH, Idriss, F. A concept of double-outlet right ventricle. J Thorac Cardiovasc Surg 1972; 64: 271–281.CrossRefGoogle ScholarPubMed
3.ZAmora, R, Moller, JH, Edwards, JE. Double-outlet right ventricle. Anatomic types and associated anomalies. Chest 1975; 68: 672–677.CrossRefGoogle Scholar
4.Anderson, RH, Becker, AE, Wilcox, BR, MacArtney, FJ, Wilkinson, JL. Surgical anatomy of double-outlet right ventricle—a reappraisal. Am J Cardiol 1983; 52: 555–559.CrossRefGoogle ScholarPubMed
5.Tynan, MJ, Becker, AE, MacArtney, FJ, Quero, Jiménez M, Shinebourne, EA, Anderson, RH. Nomenclature and classification of congenital heart disease. Br Heart J 1979; 41: 544–553.CrossRefGoogle ScholarPubMed
6.Sridaromont, S, Ritter, DG, Feldt, RH, Davis, CD, Edwards, JE. Doubleoutlet right ventricle. Anatomic and angiocardiographic correlations. Mayo Clinic Proc 1978; 53: 555–557.Google ScholarPubMed
7.Hagler, DJ, Tajik, AJ, Seward, JB, Mair, DD, Ritter, DG. Double outlet right ventricle: wide angle two dimensional echocardio-graphic observations. Circulation 1981; 63: 419–428.CrossRefGoogle Scholar
8.MacArtney, FJ, Rigby, ML, Anderson, RH, Stark, J, Silverman, NH. Double outlet right ventricle. Cross-sectional echocar diographic findings, their anatomical explanation and surgical relevance. Br Heart J 1984; 52: 164–177.CrossRefGoogle Scholar
9.Parsons, JM, Baker, EJ, Anderson, EH. Double outlet right ventricle: morphologic demonstration using nuclear magnetic resonance imaging. J Am Coll Cardiol 1991; 18: 168–178.CrossRefGoogle ScholarPubMed
10.dela Cruz, MV, Cayré, R, Arista-Salado, Martinez O, Sadowinski, S, Serrano, A. The infundibular interrelationships and the ventriculoarterial connection in double outlet right ventricle. Clinical and surgical implications. Int J Cardiol 1992; 35: 153–164.CrossRefGoogle Scholar
11.Silverman, NH, Snider, AR. Two Dimensional Echocardio-graphy in Congenital Heart Disease. Appleton-Century-Crofts, Norwalk, Connecticut, 1982, pp 9–46.Google Scholar
12.Sanders, SP, Bierman, FZ, Williams, RG. Conotruncal malfor—mations: Diagnosis in infancy usingsubxiphoid 2 dimensional echocardiography. Am J Cardiol 1982; 50: 1361–1367.CrossRefGoogle Scholar
13.Piccoli, G, Pacifico, AD, Kirklin, JW, Blackstone, EH, Kirldin, JK, Bargeron, LM Jr. Changing results and concepts in the surgical treatment of double outlet right ventricle. Analysis of 137 operations in 126 patients. Am J Cardiol 1983; 152: 549–554.CrossRefGoogle Scholar
14.Kirklin, JW, Barrat-Boyes, BC. Cardiac Surgery, Morphology, Diagnostic Criteria, Natural History, Techniques, Results and Indications. Wiley Medical Publications, New York, 1986, p. 1223.Google Scholar
15.Anderson, RH, Becker, AE. Atlas Fotográfico de Anatomía Cardiaca. Doyma SA, Barcelona, 1981, pp 4–20.Google Scholar
16.Anderson, RH. Embryology of the ventricular septum. In: Pediatric Cardiology. Anderson, RH, Shinebourne, EA (eds). Churchill Livingstone, London, 1978, pp 103–112.Google Scholar
17.Yoo, SJ, Lim, TH, Park, IS. MR anatomy of ventricular septal defect in double-outlet right ventricle with situs solitus and atrioventricularconcordance. Radiology 1991; 181: 501–505.CrossRefGoogle Scholar
18.Arteaga, M, dela Cruz, MV, Sánchez, C, Diaz, GF. Double outlet right ventricle: experimental morphogenesis in the chick embryo heart. Pediat Cardiol 1982; 3: 219–227.CrossRefGoogle ScholarPubMed
19.Yacoub, MH, Radley-Smith, R. Anatomic correction of the Taussig-Bing anomaly. J Thorac Cardiovasc Surg 1984; 88: 380–388.CrossRefGoogle ScholarPubMed
20.Sakata, R, Lecompte, I, Battisse, A, Borromée, L, Durandy, Y. Anatomic repair of anomalies ofventriculoarterial connection associated with ventricular septal defect. Criteria of surgical decision. J Thorac Cardiovasc Surg 1988; 95: 90–95.CrossRefGoogle ScholarPubMed