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How best can we name the channels seen in the setting of deficient ventricular septation?

Lookup NU author(s): Professor Bob Anderson

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Abstract

© The Author(s), 2023. Published by Cambridge University Press.Surgical repair of channels between the ventricles is enhanced when the surgeon knows precisely where to place a patch, or baffle, so as to restore septal integrity. The paediatric cardiologist should provide the necessary information. Communication will be enhanced if the same words are used to account for the structures in question. Currently, however, the same term, namely "ventricular septal defect,"is used to account for markedly different areas within the heart. Closure of perimembranous defects found in hearts with concordant or discordant ventriculo-arterial connections restores the integrity of the ventricular septum, at the same time separating the systemic and pulmonary blood streams. When both arterial trunks arise from the right ventricle, in contrast, the surgeon when placing a baffle so as to separate the blood streams, does not close the channel most frequently described as the "ventricular septal defect."In this review, we show that the perimembranous lesions as found in hearts with concordant or discordant ventriculo-arterial connections are the right ventricular entrances to the areas subtended beneath the hinges of the leaflets of the aortic or pulmonary valves. When both arterial trunks arise from the right ventricle, and the channel between the ventricles is directly subaortic, then the channel termed the "ventricular septal defect"is the left ventricular entrance to the comparable space subtended beneath the aortic root. We argue that recognition of these fundamental anatomical differences enhances the appreciation of the underlying morphology of the various lesions that reflect transfer, during cardiac development, of the aortic root from the morphologically right to the morphologically left ventricle.

Publication metadata

Author(s): Anderson RH, Spicer DE, McMahon CJ, Kumar RK, Tretter JT

Publication type: Review

Publication status: Published

Journal: Cardiology in the Young

Year: 2024

Volume: 34

Issue: 1

Pages: 1-10

Print publication date: 01/01/2024

Online publication date: 01/12/2023

Acceptance date: 02/04/2018

ISSN (print): 1047-9511

ISSN (electronic): 1467-1107

Publisher: Cambridge University Press

URL: https://doi.org/10.1017/S1047951123003943

DOI: 10.1017/S1047951123003943

PubMed id: 38037810

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