Double-outlet right ventricle. Anatomic and angiocardiographic correlations

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• Double-outlet right ventricle (DORV) presents complex congenital heart defects.
• Accurate localization of ventricular septal defects (VSDs) is critical for surgical intervention in DORV.
• Existing diagnostic methods may have limitations in fully characterizing VSDs within DORV anatomy.

Purpose of the Study:

• To evaluate the efficacy of angiocardiography in determining VSD location in DORV.
• To correlate VSD location and great-artery relationships in DORV patients.
• To assess the diagnostic value of hemodynamic data and biplane angiocardiography in DORV.

Main Methods:

• Retrospective analysis of 72 patients with diagnosed DORV.
• Utilized biplane angiocardiography, including right ventriculography and selective left ventriculography when feasible.
• Integrated hemodynamic data (systemic and pulmonary arterial saturations) with imaging findings.

Main Results:

• Only 2 of 72 patients had an intact ventricular septum.
• Identified 16 distinct anatomical variations based on VSD position and great-artery arrangement.
• Demonstrated that combining hemodynamic and angiocardiographic data allows for prediction of VSD location.

Conclusions:

• Angiocardiography is a valuable tool for precisely locating VSDs in DORV.
• Understanding the specific anatomical variations is essential for guiding surgical strategies in DORV.
• This diagnostic approach provides critical information for surgical planning and patient management.