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Angiographic anatomy of hearts with one ventricular chamber: the true single ventricle
Insights
This study analyzed 15 patients with a single ventricle, examining their atrial situs, ventricular morphology, and atrioventricular valve connections. Understanding these features is crucial for planning surgical interventions in single ventricle patients.
Area of Science:
- Congenital heart disease research
- Pediatric cardiology
- Cardiac morphology
Background:
- Single ventricle is a complex congenital heart defect.
- Accurate diagnosis and classification are vital for patient management.
- Previous studies have highlighted the variability in single ventricle anatomy.
Purpose of the Study:
- To characterize the morphological features of isolated ventricular chambers in patients with single ventricle.
- To investigate the relationship between atrial situs, ventricular morphology, and atrioventricular valve types.
- To determine the significance of these features in surgical planning for single ventricle defects.
Main Methods:
- Retrospective analysis of 218 patients with single ventricle over 10 years.
- Detailed review of angiographic data from 15 patients with isolated ventricular chambers.
- Classification of atrial situs (solitus/isomeric), ventricular trabecular pattern, and atrioventricular valve types.
Main Results:
- Fifteen patients (7% of cohort) had isolated ventricular chambers.
- Atrial situs was solitus in 6 and isomeric in 9.
- Ventricular morphology varied (right type, mixed, indeterminate); atrioventricular connections included double valves (4), common AV valve (8), and single valve (3).
Conclusions:
- Morphological features of the ventricular chamber and atrioventricular valves are key determinants in single ventricle anatomy.
- These findings are critical for effective surgical strategy development in patients with single ventricle.
- Further research into the specific subtypes of single ventricle can refine treatment approaches.
Abstract:
Fifteen patients with an isolated ventricular chamber were studied using angiography. These patients constitute 7% of the 218 patients with single ventricle who were examined at our institution over a 10-year period. The atrial situs was solitus in 6 and isomeric in 9. The ventricular chamber showed 3 varieties based on trabecular pattern: right type, mixed and indeterminate. The atrioventricular (AV) connection was through 2 valves in 4 hearts, through a common AV valve in 8 and through a single valve in 3. The morphologic features of the ventricular chamber and the AV valves are considered the most important factors for planning surgical management.