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Journal ArticleDOI

Double outlet of both ventricles: morphological, echocardiographic and surgical considerations.

TL;DR: A series of patients with the ventriculo-arterial connection best described as 'double outlet of both ventricles' are described, showing good early and midterm results can be expected subsequent to surgical repair using 2 patches for interventricular septation.
Abstract: Objectives To describe the morphology, echocardiographic features and surgical management of the entity appropriately described as 'double outlet of both ventricles'. Methods Seven patients (5 males, age 0.5-7.5 months) were diagnosed to have a unique form of subarterial ventricular septal defect (VSD) and ventriculo-arterial connection, where a muscular outlet septum straddled the crest of the ventricular septum in a cruciate manner, such that both great arteries were equally committed to both ventricles. Diagnosis was established by echocardiography, with 6 patients submitted to surgical repair by means of intracardiac routing of the left ventricle to the aorta using 2 patches. Results Surgical repair was successful in all 6 patients in whom it was attempted. In addition, 1 patient underwent concomitant repair of aortic coarctation, and 2 had closure of multiple VSDs. We lost 1 patient to follow-up after diagnosis. Follow-up with a range from 3 months to 8 years in the remaining patients revealed all to be clinically well with satisfactory growth of both outflow tracts. Conclusions We describe a series of patients with the ventriculo-arterial connection best described as 'double outlet of both ventricles'. Diagnosis is readily established by echocardiography. Good early and midterm results can be expected subsequent to surgical repair using 2 patches for interventricular septation.
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Journal ArticleDOI
TL;DR: A case of double 61 outlet both ventricles who underwent successful biventricular repair is reported and it is reported that this connection is extremely rare.
Journal ArticleDOI
20 Dec 2022-Heart
TL;DR: In this paper , the authors reviewed heart malformations with two ventricles and concordant atrioventricular connections with double outlet right ventricle (DORV), double outlet left ventriche (DOLV), and double outlet both ventrichen (DOBV) from morphological and clinical imaging perspectives.
Abstract: Hearts with double outlet ventricles and concordant atrioventricular connections account for about 1%–3% of all cases of congenital heart disease. We review hearts with two ventricles and concordant atrioventricular connections with double outlet right ventricle (DORV), double outlet left ventricle (DOLV) and double outlet both ventricles (DOBV) from the morphological and clinical imaging perspectives. These hearts are a heterogeneous group of congenital cardiac malformations with a wide range of pathophysiologies that require an individualised surgical approach based on a precise understanding of the complex cardiovascular anatomy. Owing to their differing temporal, spatial and contrast resolutions, we propose that multimodality imaging provides optimal characterisation of various intracardiac morphological features of double outlet hearts. This approach aids clinical diagnosis for optimising treatment options across these malformations.
Journal ArticleDOI
TL;DR: In this article , the authors presented an infant case diagnosed using echocardiography, CT angiography, and 3-dimensional modeling, where the double outlet of both ventricles is a rare form where both great arterial roots override the interventricular septum.
Abstract: Abstract Ventriculoarterial connection is one of the important points of the segmental approach to congenital cardiac malformations. Double outlet of both ventricles is a rare form where both great arterial roots override the interventricular septum. In this article, we aimed to draw attention to this very rare form of ventriculoarterial connection by presenting an infant case diagnosed using echocardiography, CT angiography, and 3-dimensional modelling.
Journal ArticleDOI
TL;DR: In this article, the authors presented an infant case diagnosed using echocardiography, CT angiography, and 3-dimensional modeling, where the double outlet of both ventricles is a rare form where both great arterial roots override the interventricular septum.
Abstract: Ventriculoarterial connection is one of the important points of the segmental approach to congenital cardiac malformations. Double outlet of both ventricles is a rare form where both great arterial roots override the interventricular septum. In this article, we aimed to draw attention to this very rare form of ventriculoarterial connection by presenting an infant case diagnosed using echocardiography, CT angiography, and 3-dimensional modelling.
References
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Journal ArticleDOI
TL;DR: Three anatomic variations of a partial transposition complex characterized by pulmonary and systemic arterial circuits arising entirely from the right ventricle are described.

182 citations

Journal ArticleDOI
TL;DR: A framework for the development of the DORV module for a pediatric cardiac surgical database is proposed and a careful description of the ventricular septal defect is encompassed.

157 citations

Journal ArticleDOI
TL;DR: The anatomic and cineangiocardiographic features of five patients who had this condition proved at surgery or autopsy are presented and the radiologic criteria by which double outlet left ventricle may be diagnosed considered in detail.
Abstract: In double outlet left ventricle,both the pulmonary artery and the aortaarisefromthemorphologicleft ventricle. This paper presents the anatomic and cineangiocardiographic features of five patients who had this condition proved at surgery or autopsy. The condition of the first patient was incorrectly diagnosed as transposition of the great arteries with pulmonary stenosis and ventricular septal defect; the anatomic features were correctly interpreted at operation in 1966 and appropriate repair was made, but the patient died postoperatively. The condition of the other four patients was correctly diagnosed. The second patient had Ebstein's malformation of the tricuspid valve and hypoplastic right ventricle in addition to double outlet left ventricle; her condition was not considered operable. Two patients, one with visceroatrial situs solitus, concordant d-loop and dextrocardia, were surgically treated with good long-term results. The fifth patient died 2 years postoperatively and is the first patient reported to have double outlet left ventricle with visceroatrial situs inversus, a discordant d-loop and levocardia. The segmental approach to the classification and diagnosis of connection disorders is discussed and the radiologic criteria by which double outlet left ventricle may be diagnosed considered in detail. The importance of using the radiologic projection (usually left anterior oblique) that profiles the ventricular septum is emphasized because the diagnosis can be established only by delineating the relations of the origins of the great arteries to the ventricular septum. The surgical significance of other anatomic features, including the number, size and position of ventricular septal defects and conal malformations, is also discussed.

90 citations

Journal ArticleDOI
TL;DR: Children’s Healthcare of Atlanta and the Emory University School of Medicine, Atlanta, Georgia; Pediatric Cardiology Associates and All Children's Hospital, St Petersburg, Florida; Lucille Packard Hospital at Stanford and Stanford University, Palo Alto, California; and Cardiac Unit, University College London Institute of Child Health, London, United Kingdom
Abstract: Children’s Healthcare of Atlanta and the Emory University School of Medicine, Atlanta, Georgia; Pediatric Cardiology Associates and All Children’s Hospital, St Petersburg, Florida; Lucille Packard Hospital at Stanford and Stanford University, Palo Alto, California; Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America; Cardiac Unit, University College London Institute of Child Health, London, United Kingdom

47 citations