Echocardiographic and angiographic findings in superior-inferior cardiac ventricles

The anatomy of superior-inferior ventricles was studied in 17 patients, aged 1 day to 22 years, using echocardiography and angiography. In all patients, the right ventricle was located superiorly and the left ventricle inferiorly. The right ventricular sinus was underdeveloped in 14 of the 17 patients. Conversely, the right ventricular outflow tract was normally developed in all 17 patients. The visceroatrial situs was solitus in all patients, and it was associated with a concordant D-loop in 9 patients and with a discordant L-loop in 8. There was a high incidence of associated transposition of the great arteries (9 patients) or double-outlet right ventricle (5). Segmental combination was unpredictable, D-loop being associated with L-position of the great arteries in 4 of 8 patients and L-loop being associated with D-position of the great arteries in 4 of 9. There were only 3 concordant ventriculoarterial connections. Frequently associated anomalies included ventricular septal defect (17 patients), atrioventricular valve malformations (17) subaortic conus (14) and pulmonary outflow tract stenosis or atresia (11). Criss-cross hearts were present in only 7 patients.