Classification of hearts with overriding aortic and pulmonary valves

Area of Science:

• Cardiology
• Congenital Heart Disease
• Pediatric Cardiology

Background:

• Classification of complex congenital heart malformations with overriding arterial valves remains challenging.
• Existing classification systems may lack clarity for these specific conditions.

Purpose of the Study:

• To establish clear and unambiguous criteria for classifying hearts with overriding arterial valves.
• To address the contentious nature of current classification methods.

Main Methods:

• Analysis of 67 hearts with overriding arterial valves.
• Application of the "50 per cent rule" to categorize the type of connection, independent of morphology.
• Separate description of connection type and underlying morphology.

Main Results:

• The "50 per cent rule" successfully provided unambiguous descriptions for all studied hearts.
• Identified limitations in synonyms commonly used for classification.
• Demonstrated improved distinction between conditions like double outlet right ventricle and Fallot's tetralogy.

Conclusions:

• The sequential segmental approach, when consistently applied with the "50 per cent rule", resolves ambiguity in classifying complex congenital heart malformations.
• Separate classification of connection type and morphology is crucial for accurate diagnosis.