Double-outlet right ventricle: wide-angle two-dimensional echocardiographic observations

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• M-mode echocardiography for double-outlet right ventricle (DORV) diagnosis relies on complex spatial interpretations.
• Accurate visualization of great artery origins and relationships is crucial for DORV diagnosis.

Purpose of the Study:

• To evaluate the utility of wide-angle real-time two-dimensional echocardiography for diagnosing DORV.
• To identify characteristic two-dimensional echocardiographic features of DORV.
• To assess the capability of this technique in detecting associated cardiac anomalies.

Main Methods:

• Thirty-six patients with suspected DORV underwent wide-angle real-time two-dimensional echocardiography.
• Surgical or angiographic confirmation of DORV anatomy was obtained in all patients.
• Specific echocardiographic features, including great artery orientation and valve relationships, were analyzed.

Main Results:

• Two-dimensional echocardiography revealed characteristic features: parallel great arteries originating from the right ventricle, mitral-semilunar valve discontinuity, and absence of left ventricular outflow.
• The technique accurately depicted spatial orientation of great arteries and ventricular septal defects.
• A high incidence of atrioventricular valvular anomalies, including straddling and atrioventricular canal, was unexpectedly identified.

Conclusions:

• Two-dimensional echocardiography offers improved noninvasive recognition of DORV.
• This method enhances the detection of associated atrioventricular valvular anomalies, improving preoperative assessment.
• The findings support the use of two-dimensional echocardiography for comprehensive DORV evaluation.