Ventricular septal defect with normally connected and with transposed great arteries

Area of Science:

• Cardiovascular Pathology
• Congenital Heart Disease
• Cardiac Morphology

Background:

• Ventricular septal defects (VSD) are common congenital heart abnormalities.
• Ventriculoarterial (VA) discordance presents unique challenges in cardiac anatomy.
• Understanding the interplay between VSD types and VA alignment is crucial for diagnosis and treatment.

Purpose of the Study:

• To compare the morphologic characteristics of VSDs in hearts with VA discordance versus VA concordance.
• To identify VSD types specific to each VA alignment category.
• To investigate associated valve anomalies in relation to VSD and VA alignment.

Main Methods:

• Morphologic analysis of 50 hearts with VSD and VA discordance.
• Comparison with 105 hearts exhibiting VSD and VA concordance.
• Classification and frequency analysis of VSD types within each group.

Main Results:

• Three common VSD types in VA concordant hearts were absent in VA discordant hearts.
• Two VSD types prevalent in VA discordant hearts did not occur in VA concordant specimens.
• Four VSD types (subarterial, perimembranous inlet, muscular inlet, membranous) were found in both groups, with differing frequencies.
• Perimembranous inlet VSDs were associated with tricuspid anomalies in VA concordance and mitral anomalies in VA discordance.

Conclusions:

• The spectrum of VSD morphology is distinctly different between hearts with VA concordance and VA discordance.
• Specific VSD types are characteristic of either VA concordance or discordance.
• Associated valve anomalies vary depending on the type of VSD and the VA alignment.