Double outlet right ventricle assessed with magnetic resonance imaging

Double outlet right ventricle in adults: Anatomic variability, surgical treatment, and late postoperative complications

Double outlet right ventricle (DORV) is a highly complex congenital heart disease (CHD) entity, gaining increasing interest due to the rapid progress of cardiac surgery. The number of patients operated for this congenital defect has been growing since 1980s and over following decades with active transitioning of this cohort into the adult medicine. However, the diversity of initial anomaly and performed interventions makes challenging the management of these patients. This is particularly important in the regions where specialized adult CHD cardiology still remains underdeveloped. In this review, we observe the basic principles of DORV nomenclature, main types of the operations and possible late complications. The article focuses on adult patients and offers illustrations from clinical practice.

Double Outlet Right Ventricle: In-Depth Anatomic Review Using Three-Dimensional Cardiac CT Data

Double outlet right ventricle (DORV) is a relatively common congenital heart disease in which both great arteries are connected completely or predominantly to the morphologic RV. Unlike other congenital heart diseases, DORV demonstrates various anatomic and hemodynamic subtypes, mimicking ventricular septal defect, tetralogy of Fallot, transposition of the great arteries, and functional single ventricle. Because different surgical strategies are applied to different subtypes of DORV with ventricular septal defects, a detailed assessment of intracardiac anatomy should be performed preoperatively. Due to high spatial and contrast resolutions, cardiac CT can provide an accurate characterization of various intracardiac morphologic features of DORV. In this pictorial essay, major anatomic factors affecting surgical decision-making in DORV with ventricular septal defects were comprehensively reviewed using three-dimensional cardiac CT data. In addition, the surgical procedures available for these patients and major postoperative complications are described.

Pre- and postoperative evaluation of congenital heart disease in children and adults with 64-section CT

Although echocardiography is the imaging method of choice for diagnostic, preoperative, and postoperative evaluation of congenital heart disease, computed tomography (CT) is a helpful complementary imaging modality, particularly for postoperative evaluation. A thorough understanding of the normal anatomy and the morphologic features of congenital heart diseases is a prerequisite for choosing the optimal CT technique and achieving an accurate diagnosis. Furthermore, a close collaboration with a cardiologist with special training and expertise in congenital heart diseases is required. A sequential segmental approach should be used in evaluating morphologic features, especially during the review of CT images obtained in patients with rare congenital cardiac defects and in postoperative adult patients. To accurately document and interpret the altered flow conditions in patients with congenital heart disease, knowledge of the wide spectrum of surgical procedures and familiarity with the dedicated protocols for performing 64-section CT are needed.