Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-29T12:15:09.341Z Has data issue: false hasContentIssue false

Sectional anatomy of the ventricular septal defect in double outlet right ventricle—correlation of magnetic resonance images from autopsied hearts with anatomic sections

Published online by Cambridge University Press:  19 August 2008

Shi-Joon Yoo*
Affiliation:
From the Department of Diagnostic Radiology, University of Ulsan, Seoul
Siew Yen Ho
Affiliation:
From the Department of PaediatricsNational Heart &Lung Hospitals, London
Philip J. Kilner
Affiliation:
Magnetic Resonance Unit, National Heart &Lung Hospitals, London
Jeong-Wook Seo
Affiliation:
From the Department of Pathology, College of Medicine, Seoul National University, Seoul
Robert H. Anderson
Affiliation:
From the Department of PaediatricsNational Heart &Lung Hospitals, London
*
Correspondence to Dr. Shi-Joon Yoo, Department of Diagnostic Radiology, University of Ulsan-Asan Medical Center, 388–1 Poongnap-Dong, Songpa-Ku, Seoul, 138–040, Korea. Tel. (82-2) 480-3338; Fax. (82-2) 476-4719.

Abstract

A ventricular septal defect is, almost always, an integral part of double outlet right ventricle and has been classified into the subaortic, subpulmonary, doubly committed and non-committed varieties. This study was performed to correlate the cross-sectional imaging characteristics of such ventricular septal defect in double outlet right ventricles using pathological specimens. The extent and the orientation of the outlet septum were the most important in the differentiation of the four varieties of ventricular septal defect. In the subaortic variety, the outlet septum fused with the left anterior margin of the defect, this being marked by the anterior limb of the septomarginal trabeculation. In the subpulmonary variety, the outlet septum fused with the right posterior margin of the defect, this being the posterior limb of the septomarginal trabeculation. The outlet septum was vestigial in case with doubly committed defects. In those with non-committed defects, the defect was not shown in those images or sections which demonstrated the outlet septum.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Lev, M, Bharati, S, Meng, CCL, Liberthson, RR, Paul, MH, Idriss, F. A concept of double outlet right ventricle. J Thorac Cardiovasc Surg 1972; 64: 271281.Google Scholar
2.Wilcox, BR, Hill, C, Ho, SY, Macartney, FJ, Becker, AE, Anderson, RH. Surgical anatomy of double-outlet right ventricle with situs solitus and atrioventricular concordance. J Thorac Cardiovasc Surg 1981; 82: 405417.CrossRefGoogle ScholarPubMed
3.Piccoli, G, Pacifico, AD, Kirklin, JW, Blackstone, EH, Kirklin, JK, Bargeron, LM. Changing results and concepts in the surgical treatment of double-outlet right ventricle: analysis of 139 operations in 126 patients. Am J Cardiol 1983; 52: 549554.Google Scholar
4.Anderson, RH, Becker, AE, Wilcox, BR, Macartney, FJ, Wilkinson, JL. Surgical anatomy of double-outlet right ventricle—a reappraisal. Am J Cardiol 1983; 52: 555559.Google Scholar
5.Hagler, DJ, Tajik, AJ, Seward, JB, Mair, DD, Ritter, DG. Double-outlet right ventricle: wide angle two-dimensional echocardiographic observations. Circulation 1981; 63: 419428.CrossRefGoogle ScholarPubMed
6.Macartney, FJ, Rigby, ML, Anderson, RH, Stark, J, Silverman, NH. Double outlet right ventricle: cross sectional echocardiographic findings, their anatomical explanation, and surgical relevance. Br Heart J 1984; 52: 164177.CrossRefGoogle ScholarPubMed
7.Parsons, JM, Baker, EJ, Anderson, RH, Ladusans, EJ, Hayes, A, Fagg, N, Cook, A, Qureshi, SA, Deverall, PB, Maisey, MN, Tynan, M. Double-outlet right ventricle: Morphologic demonstration using nuclear magnetic resonance imaging. J Am Coll Cardiol 1991; 18: 168178.Google Scholar
8.Yoo, S-J, Lim, TH, Park, I-S, Hong, CY, Song, MG, Kim, SH, Lee, HJ. MRanatomy of ventricular septal defect in double-outlet right ventricle with situs solitus and atrioventricular concordance. Radiology 1991; 181: 501505.CrossRefGoogle ScholarPubMed
9.Stellin, G, Ho, SY, Anderson, RH, Zuberbuhler, JR, Siewers, RD. The surgical anatomy of double-outlet right ventricle with concordant atrioventricular connection and noncommitted ventricular septal defect. J Thorac Cardiovasc Surg 1991; 102: 849855.CrossRefGoogle ScholarPubMed