Double-outlet right ventricle

2018 ◽  
pp. 560-565
Author(s):  
Shi-Joon Yoo ◽  
Willem A Helbing
Keyword(s):  
Blood Flow ◽  
Right Ventricle ◽  
Imaging Modality ◽  
Three Dimensional ◽  
Preoperative Assessment ◽  
Quantitative Information ◽  
Double Outlet Right Ventricle ◽  
Surgical Anatomy ◽  
Ventricular Volumes ◽  
The Right

Double-outlet right ventricle (DORV) encompasses a wide variety of abnormalities and requires precise demonstration of the cardiovascular abnormalities using a segmental approach for surgical decision and planning. The most important is whether the left ventricle can be directed surgically to the aorta without obstruction of the pulmonary outflow tract of the right ventricle. Echocardiography is the baseline imaging modality in preoperative assessment of DORV. In complex cases, cardiovascular magnetic resonance (CMR) provides comprehensive information regarding important surgical anatomy, blood flow, and ventricular volumes. Three-dimensional (3D) angiograms and 3D print models may provide undisputable information regarding surgical anatomy and allows practice surgery on the models prior to actual surgery. DORV is frequently associated with post-operative residual findings that require reintervention. CMR is particularly useful in post-operative assessment, as it provides accurate quantitative information regarding ventricular volumes and blood flow for decision and timing of surgical or interventional procedures.

scholarly journals Double-Outlet Right Ventricle in a Chianina Calf

Animals ◽  
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.

scholarly journals The study of systemic hemodynamic disorders of patients with varicose and post-thrombotic diseases

2020 ◽  
Vol 19 (2) ◽  
pp. 32-37
Author(s):  
I. N. Shanaev
Keyword(s):  
Blood Flow ◽  
Right Ventricle ◽  
Right Atrium ◽  
Ultrasound Examination ◽  
Anterior Wall ◽  
Right Heart ◽  
Normal Limits ◽  
Flow Through ◽  
The Right ◽  
Restrictive Type

Aim. Study of heart function in the patients with CVD. Materials and methods. 46 patients with varicosity (VD) and 34 patients with post-thrombotic disease (PTD) were examined; the control group was represented by 15 healthy volunteers. The diagnosis was established using the CEAP basic classification. The study did not include patients with a diagnosed arterial hypertension, diabetes mellitus, chronic lung disease, significant hemodynamic heart defects, coronary heart disease. Ultrasound examination of the heart and veins of the lower extremities was performed on a Saote My Lab Alpha, Acuson Sequoia 512 apparatus. In addition to the standard protocol of heart ultrasound examination, the parameters of the right heart were calculated: sizes of the right ventricle (RV), right atrium, thickness of the anterior wall of the pancreas; to assess the ejection fraction (EF) of the pancreas the mobility of the lateral edge of the tricuspid ring was calculated, and the pressure on the tricuspid valve (TV) was measured. Diastolic ventricular function was studied by spectrograms of tricuspid and mitral blood flow. Results. Most of the indicators of cardiac activity in patients with VD were within normal limits, but a tendency to increase increasing of the right heart size was noted. In addition, the thickness of the interventricular septum and the right ventricle (RV) anterior wall was found to increase from 0.8 to 1.1 cm and from 0.3 to 0.5 cm, respectively, according clinical classes from C2 to C6 (CEAP). Eject fraction (EF) of both the RV and the left ventricle (LV) were also within normal limits, but with a tendency to decrease (67.8 % – C2, to 62 % – C6). The growth of the clinical class is followed by the increasing of percentage of non-restrictive blood flow through the tricuspid valve (TV). The restrictive type of blood flow in patients with VD had not been identified. Patients with PTD also showed a tendency to increase the right heart. However, whereas the size of the RV, as a rule, did not exceed 3.0 cm, the size of the right atrium was slightly higher than normal one in the clinical class C4 and C5.6. All the patients had EF of LV within normal limits, but it slightly decreased by the growth of class. Only patient classes C3 and C4 had EF of RV within the normal range. The 18 % of patient class C5.6 had EF lower than normal with value 48%. Diastolic dysfunction (DD) of the RV was detected in 73.3% of patients with class C3 and 100% with classes C4 and C5.6. Moreover, a restrictive type of blood flow through TV appeared from class C4 and the percentage increased up to 27.2% (class C5,6). Conclusions. DD of the RV was the main hemodynamic disorder.

CLINICAL CONFERENCE

PEDIATRICS ◽  
1957 ◽  
Vol 19 (6) ◽  
pp. 1139-1147
Author(s):  
Mary Allen Engle
Keyword(s):  
Blood Flow ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Pulmonary Blood Flow ◽  
Ventricular Hypertrophy ◽  
Pulmonary Valve ◽  
Muscular Tissue ◽  
Pulmonic Stenosis ◽  
Infundibular Stenosis ◽  
The Right

Dr. Engle: When pulmonic stenosis occurs as an isolated congenital malformation of the heart, it usually is due to fusion of the valve cusps into a dome with a small hole in the center. In Figure 1 the pulmonary artery has been laid open so that one can see the three leaflets of the pulmonary valve are completely fused, and that there is only a small, central, pinpoint opening which permits blood to leave the right ventricle and enter the pulmonary circulation. Valvular pulmonic stenosis is much more common than subvalvular or infundibular stenosis, where the obstruction to pulmonary blood flow lies within the substance of the right ventricle. There it may be due to a diaphragm of tissue which obstructs the outflow of the right ventricle, or to an elongated narrow tunnel lined with thickened endocardium, or to a ridge of fibrous or muscular tissue just beneath the pulmonary valve. The changes in the cardiovascular system which result from obstructed pulmonary blood flow are so characteristic that they permit the ready recognition of this condition. Proximal to the constriction, these changes manifest the burden placed on the right ventricle, which enlarges and hypertrophies. On physical examination this is demonstrated by the precordial bulge and tapping impulse just to the left of the sternum, where the rib cage overlies the anterior (right) ventricle. Radiographically, both by fluoroscopy and in roentgenograms in the frontal and both oblique views, right ventricular enlargement is seen. In the electrocardiogram, the precordial leads show a pattern of right ventricular hypertrophy.

Pushmi-Pullyu and the Right Atrium

2011 ◽  
pp. 55-62
Author(s):  
James R. Munis
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Right Ventricle ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
The Other ◽  
Right Atrial ◽  
The One ◽  
The Right ◽  
Point Of Intersection

What does right atrial pressure (PRA) do to cardiac output (CO)? On the one hand, we've been taught that PRA represents preload for the right ventricle. That is, the higher the PRA, the greater the right ventricular output (and, therefore, CO). This is simply an application of Starling's law to the right side of the heart. On the other hand, we've been taught that PRA represents the downstream impedance to venous return (VR) from the periphery. That is, the higher the PRA, the lower the VR, and therefore, the lower the CO. The point of intersection between the 2 curves defines a unique blood flow rate, which is both CO and VR at the same time.

scholarly journals Left-sided endocarditis extending to the right chambers: Usefulness of three-dimensional echocardiography in preoperative assessment

2017 ◽  
Vol 36 (4) ◽  
pp. 319-320
Author(s):  
Zorba Blázquez Bermejo ◽  
Teresa López Fernández ◽  
Ulises Ramírez Valdiris ◽  
Juan Caro Codón ◽  
Inés Ponz de Antonio ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Preoperative Assessment ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography ◽  
The Right

Heart valve disease: tricuspid valve disease

2016 ◽  
Author(s):  
Denisa Muraru ◽  
Ashraf M. Anwar ◽  
Jae-Kwan Song
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Imaging Modality ◽  
Three Dimensional ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
Functional Tricuspid Regurgitation ◽  
Valve Pathology ◽  
Three Dimensional Echocardiography ◽  
The Right

The tricuspid valve is currently the subject of much interest from echocardiographers and surgeons. Functional tricuspid regurgitation is the most frequent aetiology of tricuspid valve pathology, is characterized by structurally normal leaflets, and is due to annular dilation and/or leaflet tethering. A primary cause of tricuspid regurgitation with/without stenosis can be identified only in a minority of cases. Echocardiography is the imaging modality of choice for assessing tricuspid valve diseases. It enables the cause to be identified, assesses the severity of valve dysfunction, monitors the right heart remodelling and haemodynamics, and helps decide the timing for surgery. The severity assessment requires the integration of multiple qualitative and quantitative parameters. The recent insights from three-dimensional echocardiography have greatly increased our understanding about the tricuspid valve and its peculiarities with respect to the mitral valve, showing promise to solve many of the current problems of conventional two-dimensional imaging. This chapter provides an overview of the current state-of-the-art assessment of tricuspid valve pathology by echocardiography, including the specific indications, strengths, and limitations of each method for diagnosis and therapeutic planning.

Sectional anatomy of the ventricular septal defect in double outlet right ventricle—correlation of magnetic resonance images from autopsied hearts with anatomic sections

1993 ◽  
Vol 3 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Shi-Joon Yoo ◽  
Siew Yen Ho ◽  
Philip J. Kilner ◽  
Jeong-Wook Seo ◽  
Robert H. Anderson
Keyword(s):  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Double Outlet Right Ventricle ◽  
Magnetic Resonance Images ◽  
Cross Sectional ◽  
Posterior Limb ◽  
Imaging Characteristics ◽  
Cross Sectional Imaging ◽  
The Right

AbstractA ventricular septal defect is, almost always, an integral part of double outlet right ventricle and has been classified into the subaortic, subpulmonary, doubly committed and non-committed varieties. This study was performed to correlate the cross-sectional imaging characteristics of such ventricular septal defect in double outlet right ventricles using pathological specimens. The extent and the orientation of the outlet septum were the most important in the differentiation of the four varieties of ventricular septal defect. In the subaortic variety, the outlet septum fused with the left anterior margin of the defect, this being marked by the anterior limb of the septomarginal trabeculation. In the subpulmonary variety, the outlet septum fused with the right posterior margin of the defect, this being the posterior limb of the septomarginal trabeculation. The outlet septum was vestigial in case with doubly committed defects. In those with non-committed defects, the defect was not shown in those images or sections which demonstrated the outlet septum.

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