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Double-outlet right ventricle revisited

Lookup NU author(s): Professor Bob Anderson

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Abstract

© 2017 The American Association for Thoracic Surgery. 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.

Publication metadata

Author(s): Ebadi A, Spicer DE, Backer CL, Fricker FJ, Anderson RH

Publication type: Article

Publication status: Published

Journal: Journal of Thoracic and Cardiovascular Surgery

Year: 2017

Volume: 154

Issue: 2

Pages: 598-604

Print publication date: 01/08/2017

Online publication date: 23/03/2017

Acceptance date: 16/03/2017

ISSN (print): 0022-5223

ISSN (electronic): 1097-685X

Publisher: Mosby Inc.

URL: https://doi.org/10.1016/j.jtcvs.2017.03.049

DOI: 10.1016/j.jtcvs.2017.03.049

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