The morphologic nature of noncommitted ventricular septal defects in specimens with double-outlet right ventricle

Tricuspid leaflet detachment improves visualization and accuracy of closure of ventricular septal defects via the transatrial route. Between July 1998 and March 2001, surgical correction was performed in 296 cases of isolated ventricular septal defect, 215 cases of tetralogy of Fallot, and 16 cases of double-outlet right ventricle. Of these, 132 patients (79 with isolated ventricular septal defect, 49 with tetralogy of Fallot, and 4 with double-outlet right ventricle) underwent transatrial repair with temporary detachment of tricuspid leaflets for ventricular septal defect closure. The septal leaflet was detached in most cases, with anterior or posterior leaflets being detached when indicated. Median duration of intensive care was 3.6 days, and median hospital stay was 7 days. There was no incidence of tricuspid regurgitation attributable to leaflet detachment, as confirmed by postoperative echocardiography. Reoperation was not required for a residual defect or tricuspid regurgitation. The benefits of temporary leaflet detachment for transatrial repair of various difficult defects far outweigh the risk of postoperative tricuspid regurgitation.

Download Full-text

Double-Outlet Right Ventricle in a Chianina Calf

Animals ◽

10.3390/ani11020318 ◽

2021 ◽

Vol 11 (2) ◽

pp. 318

Author(s):

Domenico Caivano ◽

Maria Chiara Marchesi ◽

Piero Boni ◽

Noemi Venanzi ◽

Giovanni Angeli ◽

...

Keyword(s):

Right Ventricle ◽

Septal Defect ◽

Heart Defects ◽

Double Outlet Right Ventricle ◽

Cardiac Malformation ◽

Septal Defects ◽

Congenital Cardiac Malformation ◽

The Right ◽

Similar Complex ◽

Echocardiographic Findings

Congenital heart defects have been occasionally reported in cattle and ventricular septal defect represents the most frequently encountered anomaly. The double-outlet right ventricle is a rare congenital ventriculoarterial malformation reported only in certain cattle breeds. We describe this rare and complex congenital cardiac malformation observed in a 10-day-old male Chianina calf. Clinical examination showed tachycardia, tachypnea, jugular pulses, cyanotic mucous membranes and a right apical systolic murmur. Transthoracic echocardiography revealed severe dilation of the right-sided cardiac chambers with a markedly hypoplastic left ventricle. Both aorta and pulmonary artery leaving the right ventricle in parallel alignment with the tricuspid valve were suggestive of a dual-outlet right ventricle. Interventricular and interatrial septal defects were also visualized. Post-mortem examination confirmed the echocardiographic findings. To the authors’ knowledge, a similar complex congenital cardiac malformation has not been reported in calves of the Chianina breed to date.

Download Full-text

A case of ruptured giant sinus of Valsalva aneurysm into the right ventricle in a patient with both atrial and ventricular septal defects

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2021.11.041 ◽

2021 ◽

Author(s):

Mohammed Mhanna ◽

Azizullah Beran ◽

Zeid Nesheiwat ◽

Joseph Eid ◽

Modar Alom ◽

...

Keyword(s):

Right Ventricle ◽

Sinus Of Valsalva ◽

Ventricular Septal Defects ◽

Sinus Of Valsalva Aneurysm ◽

Septal Defects ◽

The Right

Download Full-text

A Reassessment of the anatomical features of multiple ventricular septal defects

10.22541/au.163526436.68149875/v1 ◽

2021 ◽

Author(s):

Diane E. Spicer ◽

Robert Anderson ◽

Ujjwal Chowdhury ◽

Lakshmi Sankhyan ◽

Niwin George ◽

...

Keyword(s):

Right Ventricle ◽

Human Heart ◽

Ventricular Septal Defects ◽

Cardiac Defects ◽

New Developments ◽

Mortality And Morbidity ◽

Anatomical Features ◽

Congenital Cardiac Defects ◽

Septal Defects ◽

The Individual

Over the course of time, new developments associated with embryogenesis of the murine heart have served to clarify the developmental processes observed in the human heart. This evidence allows for creation of a developmental framework for many congenital cardiac defects. Here, we aim to solidify the framework related to the categorization of both solitary and multiple ventricular septal defects. Mice having genetic perturbation of the Furin enzyme have demonstrated perimembranous and juxta-arterial ventricular septal defects, permitting the inference to be made that these defects can co-exist with defects occurring within the apical muscular septum. Based on developmental evidence, furthermore, all interventricular communications can be placed into one of three groups, namely, those which are perimembranous, juxta-arterial, and muscular. All of the defects are described based on their borders as seen from the morphologically right ventricle. Our focus here will be on those defects within the muscular ventricular septum, recognizing that such defects can co-exist with those that are perimembranous. We discuss the differentiation of multiple discrete defects from those referred to as the ‘Swiss cheese’ variant. As we show, appropriate surgical management requires understanding of the specific terminology, as the surgical approach may differ depending on the combination of the individual defects. Data from the Society for Thoracic Surgeons revealed that both mortality and morbidity were increased in the setting of multiple as opposed to solitary ventricular septal defects.

Download Full-text

Surgical treatment of double outlet right ventricle

Cardiology in the Young ◽

10.1017/s1047951100005825 ◽

1997 ◽

Vol 7 (1) ◽

pp. 22-30 ◽

Cited By ~ 1

Author(s):

V.I. Burakovsky ◽

V.P. Podzolkov ◽

A.V. Ivanitsky ◽

F.R. Ragimov

Keyword(s):

Heart Failure ◽

Surgical Treatment ◽

Left Ventricle ◽

Surgical Intervention ◽

Heart Defects ◽

Double Outlet Right Ventricle ◽

Ventricular Septal Defects ◽

Surgical Experience ◽

Septal Defects ◽

Mustard Operation

AbstractForm 1980 until January 1991, 76 patients with double outlet ventricle, aged from 1 year 7 months to 23.5 years (mean age 7.5± 5.0 years) underwent surgey at the A.N. Bakoulev Inste for Cardivascular Surgery. Associated heart defects were found in 77.6% patints. In 57 patients (75%), the left ventricle opened into the subaortic infundibulum; into the subpulmonary infudibulum in four (the Tassisg-Bing anomaly) while, in 12 (15.8%), it opened under the outflow tracts of both great arteries. In two cases, (2.6%) there was a mno-committed ventricular septact. In one case (1.3%)a non-committed defect was diagnosed as coexisting with a non-commited defect was dignosed as coexisting with a Taussig-Bing anomaly. There were eight operative deaths (10.9%) among the patients undergoing radical surgery.Another theree patients with the Taussig-Bing anomaly and obstructive pulmomnary vascular disease underwent a successful palliative Mustard operation. All deaths were associated with acute heart failure and were seen only among patiens with subaortic ventricular septal defects. The important factors, which increased the risk of correction and contributed to death were inappropriate pre-operative diagnosis of complex associated defecrs and techmical mistakes during surgical intervention, the latter due to inadequate surgical experience. During the last five years, mortality decreased significatly (one death among 34 patients undergoing surgery from 1986 through January 1991)

Download Full-text

The echocardiographic anatomy of ventricular septal defects

Cardiology in the Young ◽

10.1017/s1047951100004546 ◽

1997 ◽

Vol 7 (4) ◽

pp. 471-484 ◽

Cited By ~ 11

Author(s):

Michael A. Gatzoulis ◽

Jia Li ◽

Siew Yen Ho

Keyword(s):

Right Ventricle ◽

Atrioventricular Conduction ◽

Ventricular Septal Defects ◽

Cross Sectional ◽

Septal Defects ◽

Echocardiographic Images ◽

The Right ◽

Descriptive Method ◽

Membranous Septum

AbstractMany of the controversies surrounding the description of ventricular septal defects arise from differences in the perspectives from which they are viewed. In this review, we analyse these defects as seen in cross-sectional echocardiographic images, correlating them with morphologic specimens. The classification we advocate, which now has a suitable pedigree, is a simple descriptive method distinguishing between perimembranous, muscular, and doubly committed types of defects. The approach is to categorise the defects as seen from the right ventricle, the usual port of access for surgeons. The term ‘perimembranous’ highlights the proximity of the atrioventricular conduction axis to the margin of the defects in which the remnant of the membranous septum forms a direct border. This system is applicable to all interventricular communications, no matter how malformed the heart may be in which they are enclosed.

Download Full-text

Holes and channels between the ventricles revisited

Cardiology in the Young ◽

10.1017/s104795111400170x ◽

2014 ◽

Vol 25 (6) ◽

pp. 1099-1110 ◽

Cited By ~ 7

Author(s):

Adrian Crucean ◽

William J. Brawn ◽

Diane E. Spicer ◽

Rodney C. Franklin ◽

Robert H. Anderson

Keyword(s):

Right Ventricle ◽

Aortic Coarctation ◽

Full Description ◽

Ventricular Septal Defects ◽

Children's Hospital ◽

Septal Defects ◽

Children’S Hospital ◽

The Right ◽

Phenotypic Specificity ◽

Combining Information

AbstractBackgroundAlthough holes, or channels, between the ventricles are the commonest congenital cardiac malformations, there is still no consensus as to how they can best be described and categorised. So as to assess whether it is possible to produce a potentially universally acceptable system, we have analysed the hearts categorised as having ventricular septal defects in a large archive held at Birmingham Children’s Hospital.Materials and methodsWe analysed all the hearts categorised as having isolated ventricular septal defects, or those associated with aortic coarctation or interruption in the setting of concordant ventriculo-arterial connections, in the archive of autopsied hearts held at Birmingham Children’s Hospital, United Kingdom.ResultsWe found 147 hearts within the archive fulfilling our criterions for inclusion. All could be classified within one of three groups depending on their borders as seen from the right ventricle. To provide full description, however, it was also necessary to take account of the way the defects opened to the right ventricle, and the presence or absence of alignment between the septal components.ConclusionsBy combining information on the phenotypic specificity defined on the basis of their borders, the direction of opening into the right ventricle, and the presence or absence of septal malalignment, it proved possible to categorise all hearts examined within the archive of Birmingham Children’s Hospital. Our findings have necessitated creation of new numbers within the European Paediatric Cardiac Code.

Download Full-text