Occult double RV physiology complicating VSD repair

Area of Science:

• Cardiology
• Congenital Heart Disease
• Cardiac Surgery

Background:

• Double-chamber right ventricle (DCRV) is a rare congenital heart anomaly typically diagnosed in pediatric patients.
• DCRV results from the partitioning of the right ventricle by prominent muscular bands.
• Its clinical significance in adults, particularly post-cardiac surgery, is infrequently reported.

Observation:

• This report details a case of an adult patient presenting with postoperative cardiogenic shock following ventricular septal defect repair.
• A previously undiagnosed DCRV was identified as a contributing factor to the patient's critical condition.
• The prominent muscle bundles characteristic of DCRV were found to significantly impact right ventricular function.

Findings:

• The undiagnosed DCRV presented a significant clinical challenge in an adult cardiac surgery patient.
• The anomaly contributed to the patient's cardiogenic shock, complicating postoperative recovery.
• This case underscores the potential for DCRV to manifest clinically in adulthood.

Implications:

• Recognizing DCRV is crucial for accurate diagnosis and management of complex adult cardiac conditions.
• Understanding DCRV's impact on hemodynamics is essential for surgical planning and postoperative care.
• This case expands the understanding of DCRV's clinical presentation and significance in the adult population.