A Retrospective Study on the Imaging Spectrum of Functional Single Ventricle and Its Associations

Objective  The aim of the study was to identify the various spectrum of single ventricle (SV) physiology and to correlate the anatomical variants. Materials and Methods  All congenital heart disease cases with computed tomography/magnetic resonance imaging during the period from 2008 to 2023 were retrospectively assessed. Among these, we identified those corresponding to the definition of SV ( n  = 160). In each case, we described the situs, looping, atrioventricular (AV)/ventriculoarterial (VA) connections, and associated anomalies. Descriptive statistics of each parameter were obtained and compared with similar parameters of other published studies. Results  Among the 160 cases, there were 93 males (58.1%) and 67 females (41.9%). The mean age was 8.41 ± 8.84 years. The most common defects were tricuspid atresia (TA) at 28%, double inlet left ventricle (DILV) at 23%, and AV canal defect (AVCD) at 22%. Other conditions include double outlet right ventricle, large ventricular septal defect, dextro-transposition of great arteries, levo-transposition of great arteries, mitral atresia, pulmonary atresia, hypoplastic left heart syndrome, and crisscross heart. There were 123 situs solitus, 28 right isomerism, 4 left isomerism, and 5 situs inversus cases. Among the patients with right isomerism, the most common defect was AVCD (86%). Sixty-five percent of DILV had discordant VA connections, while only 14% showed concordance. Sixty-three percent of TA cases showed VA concordance. Knowing the underlying anatomy in detail helps the physician to anticipate the wide array of problems unique to SV circulation and treat them accordingly. Conclusion  The conditions coming under the SV spectrum can be classified based on AV and VA connections. The incidence of each condition and observed associations were described.