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Horizontal ventricular septum with dextroversion: hearts with and without aortic atresia
O G Thilenius1, S Bharati, M Lev
1Section of Pediatric Cardiology, University of Chicago, Illinois.
Pediatric Cardiology
|January 1, 1987
Summary
Hearts with horizontal ventricular septums, often associated with dextroversion, may stem from early ventricular rotation. True criss-cross hearts involve a 180-degree rotation, while partial rotation leads to a superior right ventricle, guiding surgical approaches.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Congenital heart defects present diverse anatomical challenges.
- Understanding ventricular morphology is crucial for surgical planning.
- Dextroversion and septal abnormalities require detailed analysis.
Observation:
- Two cases of hearts with horizontal ventricular septum, dextroversion, ventricular septal defects, and malaligned great vessels are presented.
- One case involved aortic atresia, leading to infant mortality.
- The second case underwent successful Fontan-type physiologic correction.
Findings:
- Horizontal ventricular septums and criss-cross atrioventricular connections likely arise from varying degrees of preseptational ventricular muscle mass rotation.
- A complete 180-degree rotation defines true criss-cross hearts.
- Partial rotation consistently results in a superiorly positioned right ventricle, irrespective of other cardiac anomalies or situs.
- Surgical correction is feasible but requires individualized strategies.
Implications:
- Clarifies the embryological basis of horizontal ventricular septums and criss-cross hearts.
- Provides a framework for classifying these complex congenital anomalies.
- Highlights the importance of precise anatomical assessment for tailored surgical interventions in pediatric cardiology.
- Suggests potential for improved outcomes with individualized Fontan-type procedures.