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Papakonstantinou NA, Kanakis MA, Bobos D, Giannopoulos NM. Congenital, acquired, or both? The only two congenitally based, acquired heart diseases. J Card Surg 2021; 36:2850-2856. [PMID: 33908651 DOI: 10.1111/jocs.15588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 11/28/2022]
Abstract
Discrete subaortic stenosis (DSS) is a type of left ventricular outflow tract obstruction whereas double-chambered right ventricle is a form of right ventricular outflow tract obstruction. Both of these cardiac malformations share lots of similar characteristics which classify them as acquired developmental heart diseases despite their congenital anatomical substrate. Both of them are frequently associated to ventricular septal defects. The initial stimulus in their pathogenetic process is anatomical abnormalities or variations. Subsequently, a hemodynamic process is triggered finally leading to an abnormal subaortic fibroproliferative process with regard to DSS or to hypertrophy of ectopic muscles as far as double-chambered right ventricle is concerned. In many cases, these pathologies are developed secondarily to surgical management of other congenital or acquired heart defects. Moreover, high recurrence rates after initial successful surgical therapy, particularly regarding DSS, have been described. Finally, an interesting coexistence of DSS and double-chambered aortic ventricle has also been reported in some cases.
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Affiliation(s)
| | - Meletios A Kanakis
- Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Dimitrios Bobos
- Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Nicholas M Giannopoulos
- Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece
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Scurtu I, Tabaran F, Mircean M, Giurgiu G, Nagy A, Catoi C, Ohad DG. Combined double chambered right ventricle, tricuspid valve dysplasia, ventricular septal defect, and subaortic stenosis in a dog. BMC Vet Res 2017; 13:367. [PMID: 29187205 PMCID: PMC5708114 DOI: 10.1186/s12917-017-1275-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 11/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Double chambered right ventricle (DCRV) is a congenital heart anomaly where the right ventricle is divided into two chambers. We describe, for the first time, an unusual combination of DCRV combined with some other congenital heart defects. CASE PRESENTATION A 1.2-year-old Golden Retriever was presented with lethargy, exercise intolerance and ascites. Physical examination revealed an irregularly irregular pulse and a grade V/VI, systolic, right cranial murmur. Electrocardiography revealed widened and splintered QRS complexes with a right bundle-branch block pattern. Radiography demonstrated right-sided cardiomegaly. Two-dimensional echocardiography identified a DCRV with tricuspid valve dysplasia. The patient died despite abdominocentesis and 4 days of oral pharmacotherapy, and necropsy revealed an anomalous fibromuscular structure that divided the right ventricle into two compartments. Another finding was tricuspid valve dysplasia with hypoplasia of the posterior and septal leaflets. The anterior leaflet was prominent, being part of the anomalous structure that divided the right ventricle. Necropsy also identified a perimembranous ventricular septal defect and mild subaortic stenosis. Histopathological examination of the fibromuscular band that separated the right ventricle identified longitudinally oriented layers of dense fibrous connective tissue and myocardial cells arranged in a plexiform pattern. The muscular component was well represented at the ventral area of the fibromuscular band, and was absent in the central zone. Superficially, the endocardium presented areas of nodular hyperplasia covering mainly the fibrous part of the abnormal structure. The nodules were sharply demarcated and were composed by loosely arranged connective tissue with myxoid appearance, covered by discrete hyperplastic endocardium. CONCLUSIONS Concomitant cardiac malformations involving DCRV, tricuspid valve dysplasia, perimembranous ventricular septal defect and mild subaortic stenosis have not been previously described in veterinary medicine, and are reported here for the first time. Moreover, this is the first report of a canine patient with tricuspid valve dysplasia (TVD) and DCRV where the anterior leaflet is part of an anomalous structure dividing the right ventricle (RV) into two separate compartments.
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Affiliation(s)
- Iuliu Scurtu
- Universitatea de Stiinte Agricole si Medicina Veterinara din Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania
| | - Flaviu Tabaran
- Universitatea de Stiinte Agricole si Medicina Veterinara din Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania.
| | - Mircea Mircean
- Universitatea de Stiinte Agricole si Medicina Veterinara din Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania
| | - Gavril Giurgiu
- Universitatea de Stiinte Agricole si Medicina Veterinara din Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania
| | - Andras Nagy
- Universitatea de Stiinte Agricole si Medicina Veterinara din Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania
| | - Cornel Catoi
- Universitatea de Stiinte Agricole si Medicina Veterinara din Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania
| | - Dan G Ohad
- The Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture Food and Environment, Hebrew University of Jerusalem, P.O. Box 12, 76100, Rehovot, Israel
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Adjagba PM, Sonou A, Tossa LB, Codjo L, Hounkponou M, Moutaïrou SA, Kpossou YE, Moussé L, Tchabi Y, Sacca JV, Houénassi MD. [Isolated double-chambered right ventricle (DCRV): a case study conducted at the National University Hospital CNHU-HKM in Cotonou, Benin]. Pan Afr Med J 2017; 27:7. [PMID: 28748009 PMCID: PMC5511706 DOI: 10.11604/pamj.2017.27.7.11115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 04/22/2017] [Indexed: 11/23/2022] Open
Abstract
Le ventricule droit à double chambre (VDDC) est une malformation cardiaque rare dans laquelle le ventricule droit est divisé en deux chambres par une bande musculaire anormale. Il est associé dans 80 à 90% à d'autres malformations. L'expression clinique est variée et dépend de l'importance de l'obstruction intraventriculaire. Nous rapportons l'observation d'une adolescente de 16 ans, présentant une forme isolée de VDDC révélée par des syncopes à répétition. Le diagnostic est fait par l'échocardiographie Döppler. La résection chirurgicale de la bande musculaire anormale a été faite avec succès.
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Affiliation(s)
| | - Arnaud Sonou
- Centre Hospitalier Universitaire Départemental de l'Ouémé et du Plateau, Porto-Novo, Université d'Abomey-Calavi (UAC), Bénin
| | - Léhila Bagnan Tossa
- Service de Pédiatrie et de Génétique Médicale, CNHU-HKM, Cotonou, Université d'Abomey-Calavi (UAC)
| | - Léopold Codjo
- Centre Hospitalier Universitaire Départemental du Borgou et de l'Alibori, Parakou, Université de Parakou (UP), Bénin
| | - Murielle Hounkponou
- Service de Cardiologie, CNHU-HKM, Cotonou, Université d'Abomey-Calavi (UAC), Bénin
| | | | | | | | - Yessoufou Tchabi
- Service de Cardiologie, CNHU-HKM, Cotonou, Université d'Abomey-Calavi (UAC), Bénin
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Isolated double chambered right ventricle as a rare cause of sudden death in infancy. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2016. [DOI: 10.1016/j.ejfs.2016.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Lee WJ, Song BG, Kang GH, Park YH, Chun WJ, Oh JH. A case of asymptomatic isolated double-chambered right ventricle in an adult man. JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:579-581. [PMID: 22927061 DOI: 10.1002/jcu.21979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 08/02/2012] [Indexed: 06/01/2023]
Abstract
Double-chambered right ventricle is a rare congenital heart disease. An anomalous muscle band divides the right ventricle into two cavities, causing a variable degree of obstruction. Most cases of double-chambered right ventricle are diagnosed and treated during childhood, whereas cases of initial presentation during adulthood are very rare. We report a case of asymptomatic isolated double-chambered right ventricle incidentally found in an adult man.
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Affiliation(s)
- Won Jae Lee
- Division of Cardiology, Cardiac and Vascular Center, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Choi YJ, Park SW. Characteristics of double-chambered right ventricle in adult patients. Korean J Intern Med 2010; 25:147-53. [PMID: 20526387 PMCID: PMC2880687 DOI: 10.3904/kjim.2010.25.2.147] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Accepted: 07/21/2009] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS This study evaluated the clinical features of double-chambered right ventricle (DCRV) in adults. Most cases of DCRV are diagnosed and treated during childhood. Consequently, very few reports include cases in which its clinical characteristics are evident in adults. METHODS We reviewed the clinical data for 10 adult patients (age > or = 18 years) with DCRV. RESULTS Electrocardiogram showed right ventricular hypertrophy in 3 DCRV patients. All cases were associated with ventricular septal defect (VSD; 7 for perimembranous, 2 for muscular outlet, and 1 for the subarterial type). Surgical correction was done for 7 DCRV patients all of whom survived operations. Their follow-up echocardiogram showed the pressure gradient in their right ventricle was significantly decreased from 69.4 +/- 17.2 mmHg preoperatively to 10.2 +/- 5.0 mmHg postoperatively (p < 0.05). In the short-term follow-up, there was no significant increase in the pressure gradient in the right ventricle. CONCLUSIONS There are lots of cases of DCRV that are not diagnosed accurately in adults. In our experience, all DCRV cases had VSD and surgical correction of these cases showed excellent results. Therefore, accurate diagnosis of DCRV is necessary so that DCRV is not overlooked and operations are enabled within an appropriate time.
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Affiliation(s)
- Yu Jeong Choi
- Division of Cardiology, Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Seung Woo Park
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Gadhinglajkar SV, Sreedhar R, Chandranmahaldar DA, Minhaj MM, Tempe DK. Case 2-2010 combined surgery for coronary artery disease, mitral stenosis, and double-chamber right ventricle. J Cardiothorac Vasc Anesth 2010; 24:356-63. [PMID: 20362239 DOI: 10.1053/j.jvca.2010.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Indexed: 11/11/2022]
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Truong QA, Yared K, Maurovich-Horvat P, Siegel E, Cubeddu RJ, King ME, Heist EK, Mansour M, Holmvang G. Images in cardiovascular medicine. Double-chambered right ventricle and situs inversus with dextrocardia. Circulation 2010; 121:e229-32. [PMID: 20212287 DOI: 10.1161/cir.0b013e3181d56ebd] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Quynh A Truong
- Cardiac MR PET CT Program, Massachusetts General Hospital, Boston, MA 02114, USA
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