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Maggo K, Bhayana A, Gupta P, Gupta V, Verma A, Malik A. Double trouble - dual outflow tract obstruction in congenital heart disease: a case report. BMC Cardiovasc Disord 2024; 24:188. [PMID: 38561658 PMCID: PMC10986126 DOI: 10.1186/s12872-024-03842-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Double chambered right ventricle is a rare congenital heart disease that is characterised by the presence of an anomalous muscle bundle that divides the right ventricle into a low pressure superior (distal) chamber and a high pressure inferior (proximal) chamber. It is found in association with a ventricular septal defect in 90% cases with other associations being tetralogy of Fallot, transposition of great vessels, atrial septal defect and Ebstein's anomaly. On the other hand, subaortic membrane is a form of discrete subaortic stenosis that is characterised by a membranous diaphragm in the subvalvular location of the left ventricular outflow tract. Both of these entities are responsible for causing subvalvular outflow tract obstruction. The occurrence of double chambered right ventricle in association with subaortic membrane is an extremely rare entity with only a few case reports available in the literature. CASE REPORT A 13-year-old male child with history of chest pain and palpitations presented to the outpatient department of a tertiary care center. Transthoracic echocardiography revealed a subaortic membrane producing a pressure gradient across the left ventricular outflow tract with dilatation of the right atrium and right ventricle which could not be fully evaluated on echocardiography. Cardiac computed tomography was then performed which additionally revealed an anomalous muscle bundle coursing across the right ventricle from the septum to the subinfundibular region creating a double chambered right ventricle. The patient was then taken up for reconstruction of right ventricular outflow tract and resection of subaortic membrane. CONCLUSION Right and left outflow tract obstructions are rare congenital lesions which when seen in combination, become even more infrequent. Echocardiography is a robust tool that detects turbulent flow to identify such lesions. However, poor acoustic window may sometimes result in missing these lesions and computed tomography in such situations can play an important role in detection as well as complete preoperative imaging evaluation.
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Affiliation(s)
- Kanchan Maggo
- Department of Radiology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Aanchal Bhayana
- Department of Radiology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Pranav Gupta
- Department of Radiology, GB Pant Hospital (GIPMER), New Delhi, India.
| | - Vidushi Gupta
- Department of Radiology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Animesh Verma
- Department of Radiology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Amita Malik
- Department of Radiology, VMMC and Safdarjung Hospital, New Delhi, India
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Malone RJ, Henderson ER, Wilson ZR, McMullan MR, Skelton TN, Campbell WF, McMullan MR. Double-Chambered Right Ventricle in Adulthood: A Case Series. CASE (PHILADELPHIA, PA.) 2024; 8:202-209. [PMID: 38524987 PMCID: PMC10954581 DOI: 10.1016/j.case.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
•DCRV is a rare cardiac anomaly leading to subvalvular RVOT obstruction. •DCRV is most frequently found in children but can occur in adults. •Adults with DCRV are often initially misdiagnosed. •Echocardiography is the first-line imaging modality to visualize this anomaly. •Providers should be aware of this condition and the associated image findings.
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Affiliation(s)
| | | | - Zachary Ryan Wilson
- School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Matthew R. McMullan
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Thomas N. Skelton
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
- Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, Mississippi
| | - William F. Campbell
- School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
- Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, Mississippi
| | - Michael R. McMullan
- School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
- Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, Mississippi
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Jayaprasad N, Madhavan S. Double-chambered right ventricle in a patient with pulmonary atresia and ventricular septal defect. BMJ Case Rep 2024; 17:e257480. [PMID: 38359952 PMCID: PMC10875559 DOI: 10.1136/bcr-2023-257480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
Double-chambered right ventricle is a rare form of right ventricular outflow tract obstruction caused by anomalous hypertrophy of muscle bundles in right ventricle. Cases most often occur in children and rarely in adults. Most cases (80-90%) are associated with ventricular septal defect. We describe a case of pulmonary atresia and ventricular septal defect with double-chambered right ventricle. The interesting clinical findings, ECG, echocardiography and angiocardiography features are described here.
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Affiliation(s)
| | - Suresh Madhavan
- Cardiology, Goverment Medical College, Kottayam, Kerala, India
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Halder V, Ghosh S, Thingnam SKS, Singh H, Mishra AK, Mahajan S, Kumar R, Aggarwal P, Dutta ARS, Mishra A. Early and mid-term outcomes of double-chambered right ventricle repair: An 8-year experience. Cardiol Young 2024; 34:268-271. [PMID: 37318004 DOI: 10.1017/s1047951123001531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND/AIM Double-chambered right ventricle is a rare and progressive condition that is characterised by obstruction of the right ventricular tract. Double-chambered right ventricle is usually associated with ventricular septal defect. Early surgical intervention is recommended in patients with these defects. Based on this background, the present study aimed to review early and midterm outcomes of primary repair after double-chambered right ventricle. METHODS Between January 2014 and June 2021, 64 patients with a mean age of 13.42 ± 12.31 years underwent surgical repair for double-chambered right ventricle. The clinical outcomes of these patients were reviewed and assessed retrospectively. RESULTS An associated ventricular septal defect was present in all the recruited patients; 48 (75%) patients of sub-arterial type, 15 (23.4%) of perimembranous, and 1 (1.6%) patient of muscular type. The patients were followed up for a mean period of 46.73 ± 27.37 months. During their follow-up, a significant decrease in the mean pressure gradient from 62.33 ± 5.52 mmHg preoperatively to 15.73 ± 2.94 mmHg postoperatively was observed (p < 0.001). Notably, there were no hospital deaths. CONCLUSIONS The development of double-chambered right ventricle in association with ventricular septal defect results in an increased pressure gradient within the right ventricle. The defect needs correction in a timely manner. In our experience, the surgical correction of double-chambered right ventricle is safe and shows excellent early and mid-term results.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Amit Mishra
- Department of CTVS, UNMICRC, Ahmedabad, India
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Aoki S, Takaoka H, Ito R, Ikeuchi H, Suzuki-Eguchi N, Sasaki H, Kinoshita M, Takahashi M, Yashima S, Suzuki K, Goto H, Kitahara H, Moriya J, Matsumiya G, Kobayashi Y. Importance of the Multimodality Evaluation of a Double-chambered Right Ventricle for Surgical Indications on Admission for Acute Myocardial Infarction. Intern Med 2023; 62:1017-1022. [PMID: 35989275 PMCID: PMC10125821 DOI: 10.2169/internalmedicine.0483-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We treated a female patient known to have a double-chambered right ventricle (DCRV) who presented with symptoms of an acute myocardial infarction (AMI). Emergent coronary artery catheterization revealed acute right coronary artery (RCA) occlusion and proximal left anterior descending (LAD) stenosis. We performed percutaneous coronary intervention (PCI) for the RCA occlusion. Right heart catheterization revealed a pressure gradient across the mid-RV of 58 mmHg. Computed tomography and magnetic resonance imaging revealed no other congenital cardiac abnormalities. She underwent surgical repair of the RV stenosis and coronary artery bypass surgery for LAD stenosis.
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Affiliation(s)
- Shuhei Aoki
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Ryo Ito
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hiroki Ikeuchi
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Japan
| | - Noriko Suzuki-Eguchi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Haruka Sasaki
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Makiko Kinoshita
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Manami Takahashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Satomi Yashima
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Katsuya Suzuki
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hiroki Goto
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hideki Kitahara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Junji Moriya
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Goro Matsumiya
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
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Ceremuga B, Kozik D, Sobczyk W, Alsoufi B, Settles D, Raheja P, Ganzel B, Pahwa S. Double-Chambered Right Ventricle:An Intraoperative Surprise. J Cardiothorac Vasc Anesth 2023; 37:784-787. [PMID: 36828709 DOI: 10.1053/j.jvca.2023.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/22/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023]
Affiliation(s)
- Bradley Ceremuga
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY
| | - Deborah Kozik
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY
| | - Walter Sobczyk
- Department of Pediatric Cardiology, University of Louisville, Louisville, KY
| | - Bahaaldin Alsoufi
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY
| | - Dana Settles
- Department of Cardiovascular Anesthesia, University of Louisville, Louisville, KY
| | - Prafull Raheja
- Department of Cardiology, University of Louisville, Louisville, KY
| | - Brian Ganzel
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY
| | - Siddharth Pahwa
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY.
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Dynamic cardiac computed tomography characteristics of double-chambered right ventricle. Sci Rep 2022; 12:20607. [PMID: 36446892 PMCID: PMC9708647 DOI: 10.1038/s41598-022-25230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
To introduce image characteristics of double-chambered right ventricle on cardiac computed tomography and set a diagnostic criterion for the diagnosis. We retrospectively collected and measured the right ventricular constrictive ratio on computed tomography images in children who had simple ventricular septal defects in the past 10 years, because double-chambered right ventricle is often associated with ventricular septal defects. The right ventricular constrictive ratio was defined as the subinfundibular cross-sectional intraluminal area during end-systole divided by the area during end-diastole in the same patient. We compared the right ventricular constrictive ratio between subjects with concomitant double-chambered right ventricle and those without. 52 children were included, and 23 (44.2%) of them have concomitant double-chambered right ventricle. In most cases (n = 21; 91.3%), the hypertrophied muscular bundles occur just inferior to the level of the supraventricular crest in the right ventricle. Mean right ventricular constrictive ratio in patients with double-chambered right ventricle (15%) was significantly smaller than that without (29%). A cut-off value of a right ventricular constrictive ratio less than 20.1% was established to diagnose double-chambered right ventricle with an 89.7% sensitivity and 78. 3% specificity. Right ventricular constrictive ratio can be a valuable asset for the preoperative diagnosis of double-chambered right ventricle with cardiac computed tomography.
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Ge J, Hu T, Liu Y, Wang Q, Fan G, Liu C, Zhang J, Chen S, Maduray K, Zhang Y, Chen T, Zhong J. Case report: Double-chambered right ventricle diagnosed in a middle-aged female with hypertrophic cardiomyopathy and atrial flutter: A rare case. Front Cardiovasc Med 2022; 9:937758. [PMID: 35935646 PMCID: PMC9353184 DOI: 10.3389/fcvm.2022.937758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Double-chambered right ventricle (DCRV) is a rare congenital heart defect in adults, manifesting with progressive right ventricular outflow tract obstruction. We describe the first case of DCRV coexisting with hypertrophic cardiomyopathy, which is complicated by atrial flutter. A middle-aged woman with recurrent symptomatic atrial flutter who had previously been diagnosed with biventricular hypertrophic cardiomyopathy was admitted to our department. Echocardiography and cardiac magnetic resonance revealed asymmetrical interventricular septal hypertrophy, and abnormal muscle bundles within the right ventricle, generating an obstructive gradient. Genetic testing detected a hypertrophic cardiomyopathy-associated mutation: MYH7, c.4135G > A, p. Ala1379Thr. A diagnosis of DCRV complicated by hypertrophic cardiomyopathy and atrial flutter was made. Surgical intervention was performed, which included radiofrequency ablation, removal of abnormal muscle bundles, and ventricular septal defect repair. Intraoperative transesophageal echocardiography demonstrated the well-corrected right ventricular outflow tract. Free of early postoperative complications, the patient was discharged in sinus rhythm on the 11th day after the surgery. Unfortunately, the patient died from a sudden death 38 days following the surgery. In conclusion, the coexistence of DCRV with hypertrophic cardiomyopathy in patients is an uncommon condition. The present case highlights the importance of diagnostic imaging in the management of this disorder.
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Affiliation(s)
- Junye Ge
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tong Hu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yan Liu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qian Wang
- Department of Radiology, Qilu Hospital, Shandong University, Jinan, China
| | - Guanqi Fan
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chuanzhen Liu
- Department of Cardiovascular Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - Jun Zhang
- Department of Cardiovascular Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - Shiming Chen
- Department of Pathology, Qilu Hospital, Shandong University, Jinan, China
| | - Kellina Maduray
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yun Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tongshuai Chen
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Tongshuai Chen,
| | - Jingquan Zhong
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Cardiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
- Jingquan Zhong,
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Fukui T, Miyoshi M, Ogasawara N. Leadless pacemaker implantation in a patient with a double-chambered right ventricle. BMJ Case Rep 2022; 15:e251496. [PMID: 35840166 PMCID: PMC9295649 DOI: 10.1136/bcr-2022-251496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Tomoki Fukui
- Cardiology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - Miwa Miyoshi
- Cardiology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - Nobuyuki Ogasawara
- Cardiology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
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10
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Sharma A, Chera HH, Agarwal S, Michelakis N, Gubernikoff G, Gopal AS. Double Chamber Right Ventricle with New-Onset Biventricular Failure in an Octogenarian. CASE 2022; 6:178-182. [PMID: 35818489 PMCID: PMC9270667 DOI: 10.1016/j.case.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Akanksha Sharma
- Department of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Habib Hymie Chera
- Department of Cardiology, NYU Long Island School of Medicine, Mineola, New York
| | - Siddharth Agarwal
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | | | - George Gubernikoff
- Department of Cardiology, NYU Long Island School of Medicine, Mineola, New York
| | - Aasha S. Gopal
- Department of Cardiology, NYU Long Island School of Medicine, Mineola, New York
- Correspondence: Aasha S. Gopal, MS, MD, Clinical Associate Professor of Medicine, NYU Langone Cardiology Associates–Mineola, 212 Jericho Turnpike, 2nd Floor, Mineola, New York 11501.
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An extremely rare association of coarctation of aorta with double chambered right ventricle: double-trouble causing bi-ventricular failure in a child. Cardiol Young 2022; 32:484-486. [PMID: 34348820 DOI: 10.1017/s1047951121003085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Double chambered right ventricle is a rare cardiac defect characterised by an obstructive hypertrophied muscle bundle in the right ventricle. The common associated lesions are ventricular septal defect followed by sub-aortic membrane. We report a child who had coarctation of aorta in association with double chambered right ventricle. This case is being reported for its rarity and challenges in management.
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Sambugaro B, De Gennaro C, Vettorato E. Anaesthetic management and complications during cutting balloon and high‐pressure balloon dilation in a dog with a double‐chambered right ventricle. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Otero-Luna A, Ghiroli S, Hsia TY, Fahey J, Elder RW. Diagnosis, surgical management, and long-term outcomes of double chambered right ventricle: a rare and challenging disease in the adult population. PROGRESS IN PEDIATRIC CARDIOLOGY 2021. [DOI: 10.1016/j.ppedcard.2021.101417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Winter RL, Clark WA, Kochie SL, Rhinehart JD. Long-term relief of obstruction in a dog with double-chambered right ventricle using combined cutting balloon and high-pressure balloon dilation. J Vet Cardiol 2021; 36:180-185. [PMID: 34303120 DOI: 10.1016/j.jvc.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/26/2021] [Accepted: 06/10/2021] [Indexed: 10/21/2022]
Abstract
A 4-month-old intact female Golden Retriever dog was diagnosed with double-chambered right ventricle (DCRV) without infundibular stenosis, tricuspid valve dysplasia, and subsequent severe right atrial enlargement and was referred for combined cutting balloon and high-pressure balloon dilation. On presentation, these diagnoses were confirmed, and the peak systolic pressure gradient across the DCRV obstructive lesion assessed by continuous wave Doppler interrogation was 80 mm Hg. The obstructive lesion within the mid-right ventricle had a diameter of 6 mm through which blood flowed from the proximal right ventricular (RV) chamber to the distal RV chamber. The following day, general anesthesia was induced, and a minimally invasive balloon dilation was performed. A cutting balloon was inflated across the mid-RV obstructive lesion, followed by an inflation of a high-pressure balloon across this lesion. The high-pressure balloon catheter that was used had a diameter roughly 1.5 times the diameter of the pulmonary annulus. The following day, echocardiographic evaluation of the patient revealed a peak systolic pressure gradient across the DCRV obstructive lesion of 16 mm Hg, with a RV diameter at the level of obstruction of 11 mm. Twelve months later, the dog remains asymptomatic, right atrial size has decreased, and has a peak systolic pressure gradient across the DCRV lesion of 20 mm Hg.
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Affiliation(s)
- R L Winter
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, 43220, USA.
| | - W A Clark
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, 43220, USA
| | - S L Kochie
- Oradell Animal Hospital, 580 Winters Ave, Paramus, NJ, 07405, USA
| | - J D Rhinehart
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, 43220, USA
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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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Early and late outcomes of surgical repair of double-chambered right ventricle: a single-centre experience. Cardiol Young 2020; 30:409-412. [PMID: 32063236 DOI: 10.1017/s1047951120000244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Double-chambered right ventricle is characterised by division of the outlet portion of the right ventricle by hypertrophy of the septoparietal trabeculations into two parts. We aim to report our experiences regarding the presenting symptoms of double-chambered right ventricle, long-term prognosis, including the recurrence rate and incidence of arrhythmias after surgery. METHODS We retrospectively investigated 89 consecutive patients who were diagnosed to have double-chambered right ventricle and underwent a surgical intervention from 1995 to 2016. The data obtained by echocardiography, cardiac catheterisation, and surgical findings as well as post-operative follow-up, surgical approaches, post-operative morbidity, mortality, and cardiac events were evaluated. RESULTS Median age at the time of diagnosis was 2 months and mean age at the time of operation was 5.3 years. Concomitant cardiac anomalies were as follows: perimembranous ventricular septal defect (78 patients), atrial septal defect (9 patients), discrete subaortic membrane (32 patients), right aortic arch (3 patients), aortic valve prolapse and/or mild aortic regurgitation (14 patients), and left superior caval vein (2 patients). The mean follow-up period was 4.86 ± 4.6 years. In these patients, mean systolic pressure gradient in the right ventricle by echocardiography before, immediately, and long-term after surgical intervention was 66.3, 11.8, and 10.4 mmHg, respectively. There were no deaths during the long-term follow-up period. Surgical reinterventions were performed for residual ventricular septal defect (2), residual pulmonary stenosis (1), and severe tricuspid insufficiency (1). CONCLUSION The surgical outcomes and prognosis of double-chambered right ventricle are favourable, recurrence and fatal arrhythmias are unlikely in long-term follow-up.
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Misra S, Mohanty S, Sathia S, Mahapatra RP. Isolated double-chambered right ventricle in an adult patient: intraoperative imaging with three-dimensional transoesophageal echocardiography. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-2. [PMID: 32352056 PMCID: PMC7180532 DOI: 10.1093/ehjcr/ytaa035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/18/2019] [Accepted: 01/28/2020] [Indexed: 11/14/2022]
Affiliation(s)
- Satyajeet Misra
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Sijua, Patrapada, Bhubaneswar 751006, Odisha, India
| | - Satyapriya Mohanty
- Department of Cardiac Surgery, All India Institute of Medical Sciences (AIIMS), Sijua, Patrapada, Bhubaneswar 751006, Odisha, India
| | - Siddhartha Sathia
- Department of Cardiac Surgery, All India Institute of Medical Sciences (AIIMS), Sijua, Patrapada, Bhubaneswar 751006, Odisha, India
| | - Rudra Pratap Mahapatra
- Department of Cardiac Surgery, All India Institute of Medical Sciences (AIIMS), Sijua, Patrapada, Bhubaneswar 751006, Odisha, India
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18
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Mokkarala M, Ballard DH, Wesley RA, Gutierrez FR, Javidan-Nejad C, Singh GK, Woodard PK, Lindley KJ. Coronary-cameral fistula with double-chambered right ventricle: appearance on cardiac magnetic resonance imaging and 3D printed anatomic modeling. Clin Imaging 2019; 59:84-87. [PMID: 31760282 DOI: 10.1016/j.clinimag.2019.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/17/2019] [Accepted: 10/31/2019] [Indexed: 12/16/2022]
Abstract
The present case illustrates cardiac magnetic resonance imaging (MRI) and three-dimensional (3D) printed anatomic model findings of a coronary-cameral fistula (CCF) and double-chambered right ventricle (DCRV). A pregnant woman presented with palpitations and near syncope. A non-contrast cardiac MRI showed CCF connecting to a DCRV. Post-delivery, the patient had a contrast-enhanced MRI and 3D printed anatomic model to better evaluate her aberrant anatomy.
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Affiliation(s)
- Mahati Mokkarala
- Washington University School of Medicine, St. Louis, MO, United States of America.
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Robert A Wesley
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Fernando R Gutierrez
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Cylen Javidan-Nejad
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Gautam K Singh
- Department of Pediatrics, Washington University School of Medicine, Saint Louis Children's Hospital, St. Louis, MO, United States of America
| | - Pamela K Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Kathryn J Lindley
- Cardiovascular Division, Internal Medicine, Washington University School of Medicine, St. Louis, MO, United States of America
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19
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Rajiah P, MacNamara J, Chaturvedi A, Ashwath R, Fulton NL, Goerne H. Bands in the Heart: Multimodality Imaging Review. Radiographics 2019; 39:1238-1263. [DOI: 10.1148/rg.2019180176] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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20
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Grossi R, Béïque F, Hatzakorzian R, Codère-Maruyama T, Schricker T, Villeneuve V. Transesophageal Echocardiography in an Adult Patient With Double-Chambered Right Ventricle. A A Pract 2019; 12:85-87. [PMID: 30169382 DOI: 10.1213/xaa.0000000000000870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Raphael Grossi
- From the Department of Cardiac Anesthesia, McGill University Health Center, Glen Site, Royal Victoria Hospital, Montréal, Québec, Canada
| | - François Béïque
- Department of Cardiac Anesthesia, Jewish General Hospital, Montréal, Québec, Canada
| | - Roupen Hatzakorzian
- From the Department of Cardiac Anesthesia, McGill University Health Center, Glen Site, Royal Victoria Hospital, Montréal, Québec, Canada.,Department of Critical Care Medicine, McGill University Health Center, Glen Site, Royal Victoria Hospital, Montréal, Québec, Canada
| | - Takumi Codère-Maruyama
- From the Department of Cardiac Anesthesia, McGill University Health Center, Glen Site, Royal Victoria Hospital, Montréal, Québec, Canada
| | - Thomas Schricker
- From the Department of Cardiac Anesthesia, McGill University Health Center, Glen Site, Royal Victoria Hospital, Montréal, Québec, Canada
| | - Valérie Villeneuve
- From the Department of Cardiac Anesthesia, McGill University Health Center, Glen Site, Royal Victoria Hospital, Montréal, Québec, Canada
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21
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Bhambi NS, Shah A, Sarte P, Laughrun DR. Bacterial endocarditis presenting in an adult patient with undiagnosed double-chambered right ventricle. Clin Case Rep 2019; 7:893-897. [PMID: 31110710 PMCID: PMC6510006 DOI: 10.1002/ccr3.2107] [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: 01/10/2019] [Revised: 02/15/2019] [Accepted: 02/23/2019] [Indexed: 11/08/2022] Open
Abstract
Double-chambered right ventricle (DCRV) is a rare congenital heart defect often associated with ventricular septal defect and pulmonary stenosis. Cardiac catheterization or magnetic resonance imaging can differentiate between DCRV and Tetralogy of Fallot when echocardiogram is inconclusive. Patients are at an increased risk for bacterial endocarditis.
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Affiliation(s)
- Neil Salil Bhambi
- Department of Internal MedicineKeck School of Medicine of the University of Southern CaliforniaLos AngelesCalifornia
| | - Abhishek Shah
- Department of Cardiovascular MedicineKeck School of Medicine of the University of Southern CaliforniaLos AngelesCalifornia
| | - Patrick Sarte
- Department of Internal MedicineKeck School of Medicine of the University of Southern CaliforniaLos AngelesCalifornia
| | - David Robert Laughrun
- Department of Cardiovascular MedicineKeck School of Medicine of the University of Southern CaliforniaLos AngelesCalifornia
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22
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Shaikh K, Jayawerdena E, Budoff M, Pillutla P. Double chambered right ventricle diagnosed on cardiac CTA: A case series. J Cardiovasc Comput Tomogr 2019; 14:e58-e60. [PMID: 30850276 DOI: 10.1016/j.jcct.2019.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 02/11/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Kashif Shaikh
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, CA, 90502, USA.
| | - Eranthi Jayawerdena
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, CA, 90502, USA
| | - Matthew Budoff
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, CA, 90502, USA
| | - Priya Pillutla
- Department of Medicine, Division of Cardiology, Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
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23
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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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25
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Barik R. Role of Echocardiograghy in Treating a Case of Double Chamber Right Ventricle with Delayed Presentation. J Cardiovasc Echogr 2017; 27:10-13. [PMID: 28465983 PMCID: PMC5353467 DOI: 10.4103/2211-4122.199058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The clinical diagnosis of double chamber right ventricle (DCRV) is not straightforward. Clinical history, clinical examination, 12-lead electrocardiogram, chest X-ray, and Echocardiography (echo) contribute to morphological diagnosis. Cardiac catheterization is essential for hemodynamic evaluation. A thorough presurgical workup helps the cardiac surgeon to choose the appropriate surgical approach and timing of surgery in an individual case. We present a case of a DCRV who presented to us in the fifth decade of life. Echo confirmed the morphological diagnosis and cardiac catheterization complemented the exact pull back gradient across the obstruction in the right ventricle. This patient was suggested muscle bundle resection and ventricular septal defect closure using right atrial approach.
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Affiliation(s)
- Ramachandra Barik
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Telengana, India
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26
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Chellappan S, Sahu B, Sathe YC. Isolated Double-chambered Right Ventricle with Intact Interventricular Septum. J Cardiovasc Echogr 2017; 26:127-130. [PMID: 28465979 PMCID: PMC5224663 DOI: 10.4103/2211-4122.192180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Double-chambered right ventricle (DCRV) is a developmental cardiac anomaly in which anomalous muscle bundles divide the right ventricular (RV) cavity into two chambers. It is usually associated with other congenital cardiac defects, of which ventricular septal defect is the most common association. Isolated DCRV with an intact interventricular septum is very rarely reported. It manifests itself usually in adolescence and adults as the obstruction progresses gradually. It is important to recognize this anomaly as it can progress to severe RV failure if unaddressed. We report a 13-year-old male who presented to us with an isolated DCRV. He successfully underwent a resection of the RV cavity anomalous muscle bundles. We also stress on the utility of transesophageal echocardiography intraoperatively which accurately delineates the location of the muscle bundles and helps in evaluating the adequacy of resection postsurgery.
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Affiliation(s)
- Subramanian Chellappan
- Department of Pediatric Cardiac Anaesthesia, Sri Satya Sai Sanjeevani Hospital, Chhattisgarh, India
| | - Balaswaroop Sahu
- Department of Pediatric Cardiac Anaesthesia, Sri Satya Sai Sanjeevani Hospital, Chhattisgarh, India
| | - Yogesh C Sathe
- Department of Pediatric Cardiology, Sri Satya Sai Sanjeevani Hospital, Chhattisgarh, India
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27
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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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28
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Markley RR, Ali A, Potfay J, Paulsen W, Jovin IS. Echocardiographic Evaluation of the Right Heart. J Cardiovasc Ultrasound 2016; 24:183-190. [PMID: 27721944 PMCID: PMC5050302 DOI: 10.4250/jcu.2016.24.3.183] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 05/03/2016] [Accepted: 07/26/2016] [Indexed: 12/23/2022] Open
Abstract
The appropriate use of echocardiography may reduce the need for invasive diagnostic cardiac procedures. The right side of the heart has recently gained interest among cardiologists as it became clear that abnormalities of the right heart morphology and function are associated with increased morbidity and mortality. Echocardiography is easy to perform, relatively cheap, readily available and do not pose the risk of ionizing radiation. Conventional 2D and, more recently, 3D echocardiography provides pertinent anatomic and physiologic information about the right side of the heart. Because of the advantages and simplicity of echocardiography it continues to be an excellent tool for evaluating the structure and function of the right side of the heart. This review outlines the uses of echocardiography in evaluating the right heart structure and function.
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Affiliation(s)
- Roshanak R Markley
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Asghar Ali
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.; Department of Medicine, McGuire VA Medical Center, Richmond, VA, USA
| | - Jonathan Potfay
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.; Department of Medicine, McGuire VA Medical Center, Richmond, VA, USA
| | - Walter Paulsen
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Ion S Jovin
- Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.; Department of Medicine, McGuire VA Medical Center, Richmond, VA, USA
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29
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Maddali MM, Junghare SW, Kandachar PS, Al-Ghanami HS, Nagy ZL, Jayatilaka CM. An Unusual Cause for an Elevated Right Ventricular Pressure Following Bentall Procedure With Ventricular Septal Defect Closure. J Cardiothorac Vasc Anesth 2016; 31:388-390. [PMID: 27542903 DOI: 10.1053/j.jvca.2016.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Madan Mohan Maddali
- Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman.
| | - Sandip Waman Junghare
- Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman
| | | | | | - Zsolt Lajos Nagy
- Department of Cardiothoracic Surgery, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman
| | - Cheskey Manoj Jayatilaka
- Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Sultanate of Oman
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30
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Nikolic A, Jovovic L, Ilisic T, Antonic Z. An (In)Significant Ventricular Septal Defect and/or Double-Chambered Right Ventricle: Are There Any Differences in Diagnosis and Prognosis in Adult Patients. Cardiology 2016; 134:375-80. [PMID: 27111550 DOI: 10.1159/000444743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/16/2016] [Indexed: 11/19/2022]
Abstract
A double-chambered right ventricle (DCRV) is an uncommon congenital anomaly: the right ventricle (RV) is divided into two chambers due to the presence of an abnormally located muscular band or anomalous muscle hypertrophy in the subinfundibular part of RV outflow tract, with a variable degree of obstruction. Generally, DCRV is well recognized in childhood and misdiagnosed in adult patients. Transthoracic and/or transesophageal echocardiography are the mx0435;thods of choice for the diagnosis of DCRV. Due to limitations of echocardiography in adult patients, this entity may be missed, particularly if it presents concomitant with other congenital defects, and therefore additional imaging methods such as MRI or cardiac catheterization are required for a definitive diagnosis.
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31
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Kharwar RB, Dwivedi SK, Sharma A. Double-Chambered Right Ventricle with Ventricular Septal Defect and Subaortic Membrane- Three-Dimensional Echocardiographic Evaluation. Echocardiography 2015; 33:323-7. [PMID: 26581185 DOI: 10.1111/echo.13104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Double-chambered right ventricle (DCRV) is a rare congenital anomaly in which the right ventricle is divided into two compartments with varying pressures due to an anomalous muscle bundle. Here, we describe a case of an adolescent male with DCRV with associated ventricular septal defect and subaortic membrane. Two-dimensional and three-dimensional transthoracic echocardiography with color flow clearly outlined all the three cardiac anomalies as well as their relationship with each other. The diagnosis was confirmed by cardiac catheterization. The patient underwent successful surgical resection of the anomalous muscle bundle along with repair of the associated anomalies.
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Affiliation(s)
- Rajiv Bharat Kharwar
- Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India
| | | | - Akhil Sharma
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
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32
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Amano M, Izumi C, Hayama Y, Onishi N, Tamaki Y, Enomoto S, Miyake M, Tamura T, Kondo H, Kaitani K, Yamanaka K, Nakagawa Y. Surgical Outcomes and Postoperative Prognosis Beyond 10 Years for Double-Chambered Right Ventricle. Am J Cardiol 2015; 116:1431-5. [PMID: 26358511 DOI: 10.1016/j.amjcard.2015.07.069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 07/21/2015] [Accepted: 07/21/2015] [Indexed: 11/18/2022]
Abstract
Double-chambered right ventricle (DCRV) is a rare condition. Stenosis of DCRV is progressive, and early surgical intervention is recommended for patients whose symptoms and/or pressure overload of right ventricular (RV) inflow are progressive. However, there are few data regarding the postoperative course of DCRV, and the surgical indications for asymptomatic patients remain to be determined. We retrospectively investigated 38 consecutive patients who were diagnosed with DCRV and underwent surgical intervention from 1981 to 2009. Moreover, we identified 29 patients in whom long-term follow-up transthoracic echocardiographic data were available and investigated the postoperative recurrence of DCRV by evaluating the systolic pressure of RV inflow before, immediately, and in the long term after surgical intervention. The mean follow-up period was 11.0 ± 8.8 years. There were no deaths and no surgical reinterventions during the long-term follow-up period. Among 29 patients with long-term follow-up echocardiographic data, there was no recurrence of DCRV. In these patients, the systolic pressure of RV inflow by echocardiography before, immediately, and long-term after surgical intervention was 80 ± 26, 30 ± 11, and 25 ± 6 mm Hg, respectively. In conclusion, the surgical outcomes and postoperative prognosis beyond 10 years of DCRV are favorable, and neither recurrence of DCRV nor fatal arrhythmias develop during the long-term follow-up period.
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Affiliation(s)
- Masashi Amano
- Department of Cardiology, Tenri Hospital, Tenri, Japan.
| | - Chisato Izumi
- Department of Cardiology, Tenri Hospital, Tenri, Japan
| | - Yukiko Hayama
- Department of Cardiology, Tenri Hospital, Tenri, Japan
| | - Naoaki Onishi
- Department of Cardiology, Tenri Hospital, Tenri, Japan
| | - Yodo Tamaki
- Department of Cardiology, Tenri Hospital, Tenri, Japan
| | | | - Makoto Miyake
- Department of Cardiology, Tenri Hospital, Tenri, Japan
| | | | | | | | - Kazuo Yamanaka
- Department of Cardiovascular Surgery, Tenri Hospital, Tenri, Japan
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33
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Baxi AJ, Tavakoli S, Vargas D, Restrepo CS. Bands, Chords, Tendons, and Membranes in the Heart: An Imaging Overview. Curr Probl Diagn Radiol 2015; 45:380-391. [PMID: 26433812 DOI: 10.1067/j.cpradiol.2015.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 08/24/2015] [Indexed: 11/22/2022]
Abstract
Crests, bands, chords, and membranes can be seen within the different cardiac chambers, with variable clinical significance. They can be incidental or can have clinical implications by causing hemodynamic disturbance. It is crucial to know the morphology and orientation of normal structures, aberrant or accessory muscles, and abnormal membranes to diagnose the hemodynamic disturbance associated with them. Newer generation computed tomographic scanners and faster magnetic resonance imaging sequences offer high spatial and temporal resolution allowing for acquisition of high resolution images of the cardiac chambers improving identification of small internal structures, such as papillary muscles, muscular bands, chords, and membranes. They also help in identification of other associated complications, malformations, and provide a road map for treatment. In this article, we review cross-sectional cardiac imaging findings of normal anatomical variants and distinctive imaging features of pathologic bands, chords, or membranes, which may produce significant hemodynamic changes and clinical symptomatology.
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Affiliation(s)
- Ameya Jagdish Baxi
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX.
| | - Sina Tavakoli
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Daniel Vargas
- Department of Radiology, University of Colorado Hospital, Denver, CO
| | - Carlos S Restrepo
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX
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34
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Mohan JC, Mohan V. Bilateral outflow obstructions without ventricular septal defect in an adult: Illustrated by real-time 3D echocardiography. Indian Heart J 2015; 67:371-4. [PMID: 26304572 DOI: 10.1016/j.ihj.2015.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 04/25/2015] [Indexed: 10/23/2022] Open
Abstract
Double-chambered right ventricle with discrete subaortic stenosis without ventricular septal defect is rare in adults. This report shows incremental value of 3D echocardiography in delineating the pathoanatomy of these lesions.
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Affiliation(s)
- Jagdish C Mohan
- Prof, Director, Department of Cardiac Sciences, Fortis Hospital, Shalimar Bagh, Delhi 110088, India.
| | - Vishwas Mohan
- Resident, Department of Cardiac Sciences, Fortis Hospital, Shalimar Bagh, Delhi 110088, India
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Myeong JC, Chin JY, Choi JH, Rah YM, Park JH. Tricuspid and pulmonary valve endocarditis associated with double-chambered right ventricle. KOSIN MEDICAL JOURNAL 2015. [DOI: 10.7180/kmj.2015.30.1.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
We report a rare case of tricuspid valve and pulmonary valve endocarditis associated with a double-chambered right ventricle in an adult female with pulmonary artery aneurysm and septic pulmonary embolism by Streptococcus mitis. She was treated with aggressive antibiotic therapy followed by debridement of the infective lesion of tricuspid valve, pulmonary valve replacement using xenograft and resection of obstructing muscular bundles in right ventricle.
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Hu G, Zhu X, Li G, Jiang F, Li J. A Case Report of Double-Chambered Right Ventricle Associated with Subaterial Ventricular Septal Defect and Rupture of Right Coronary Sinus Aneurysm. Echocardiography 2015; 32:1438-40. [PMID: 25728324 DOI: 10.1111/echo.12923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Double-chambered right ventricle (DCRV) is a rare congenital heart disease in which the right ventricle (RV) is divided into two chambers by anomalous muscle bundles. Here, we report a case of DCRV associated with subarterial ventricular septal defect (VSD) and rupture of right coronary sinus aneurysm (RCSA); the patient was diagnosed by echocardiography and later confirmed by surgical operation.
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Affiliation(s)
- Guobing Hu
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Xiangming Zhu
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Guojie Li
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Feng Jiang
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Jing Li
- Department of Ultrasound, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
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Kokotsakis J, Rouska EG, Harling L, Ashrafian H, Anagnostakou V, Charitos C, Athanasiou T. Right ventricular outflow tract obstruction caused by double-chambered right ventricle presenting in adulthood. Tex Heart Inst J 2014; 41:425-8. [PMID: 25120399 DOI: 10.14503/thij-13-3398] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Congenital heart diseases that cause obstruction of the right ventricular outflow tract are often difficult to diagnose. We report the case of a 49-year-old man who presented with long-standing shortness of breath on exertion. Imaging revealed right ventricular outflow tract obstruction caused by a double-chambered right ventricle, and he was referred for surgical correction. This case emphasizes both the detailed perioperative evaluation that is needed when diagnosing adults who present with manifestations of congenital heart disease and a method of successful surgical correction that resulted in symptom resolution.
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Affiliation(s)
- John Kokotsakis
- Second Departments of Cardiac Surgery (Drs. Anagnostakou, Charitos,and Kokotsakis) and Cardiology (Dr. Rouska), Evangelismos General Hospital, 10376 Athens, Greece; and Department of Surgery and Cancer (Drs. Ashrafian, Athanasiou, and Harling), Imperial College London, London W2 1NY, United Kingdom
| | - Efthymia G Rouska
- Second Departments of Cardiac Surgery (Drs. Anagnostakou, Charitos,and Kokotsakis) and Cardiology (Dr. Rouska), Evangelismos General Hospital, 10376 Athens, Greece; and Department of Surgery and Cancer (Drs. Ashrafian, Athanasiou, and Harling), Imperial College London, London W2 1NY, United Kingdom
| | - Leanne Harling
- Second Departments of Cardiac Surgery (Drs. Anagnostakou, Charitos,and Kokotsakis) and Cardiology (Dr. Rouska), Evangelismos General Hospital, 10376 Athens, Greece; and Department of Surgery and Cancer (Drs. Ashrafian, Athanasiou, and Harling), Imperial College London, London W2 1NY, United Kingdom
| | - Hutan Ashrafian
- Second Departments of Cardiac Surgery (Drs. Anagnostakou, Charitos,and Kokotsakis) and Cardiology (Dr. Rouska), Evangelismos General Hospital, 10376 Athens, Greece; and Department of Surgery and Cancer (Drs. Ashrafian, Athanasiou, and Harling), Imperial College London, London W2 1NY, United Kingdom
| | - Vania Anagnostakou
- Second Departments of Cardiac Surgery (Drs. Anagnostakou, Charitos,and Kokotsakis) and Cardiology (Dr. Rouska), Evangelismos General Hospital, 10376 Athens, Greece; and Department of Surgery and Cancer (Drs. Ashrafian, Athanasiou, and Harling), Imperial College London, London W2 1NY, United Kingdom
| | - Christos Charitos
- Second Departments of Cardiac Surgery (Drs. Anagnostakou, Charitos,and Kokotsakis) and Cardiology (Dr. Rouska), Evangelismos General Hospital, 10376 Athens, Greece; and Department of Surgery and Cancer (Drs. Ashrafian, Athanasiou, and Harling), Imperial College London, London W2 1NY, United Kingdom
| | - Thanos Athanasiou
- Second Departments of Cardiac Surgery (Drs. Anagnostakou, Charitos,and Kokotsakis) and Cardiology (Dr. Rouska), Evangelismos General Hospital, 10376 Athens, Greece; and Department of Surgery and Cancer (Drs. Ashrafian, Athanasiou, and Harling), Imperial College London, London W2 1NY, United Kingdom
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Long-term natural history and postoperative outcome of double-chambered right ventricle—Experience from two tertiary adult congenital heart centres and review of the literature. Int J Cardiol 2014; 174:662-8. [DOI: 10.1016/j.ijcard.2014.04.177] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/14/2014] [Accepted: 04/17/2014] [Indexed: 11/29/2022]
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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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Shankarappa RK, Patra S, Karur S, Singh A, Nanjappa MC, Chandrasekaran D. An adult patient of double-chambered right ventricle with ventricular septal defect incidentally diagnosed after presentation with acute myocardial infarction. Echocardiography 2013; 30:E312-4. [PMID: 24103007 DOI: 10.1111/echo.12334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The double-chambered right ventricle (DCRV) is a rare congenital heart disease caused by hypertrophic anomalous muscle bands that divide the ventricular cavity, resulting in the formation of a high-pressure proximal chamber and other low-pressure distal one. Because of its evolving nature, its diagnosis is usually made during childhood/adolescence and very rarely during adulthood. It accounts for approximately 0.5-1% of patients with congenital heart disease. We report a case of a 50-year-old man who presented to us with acute inferior wall myocardial infarction (MI). Echocardiography revealed the features of DCRV and ventricular septal defect. Coronary angiogram revealed significant stenosis in right coronary artery. This is the first case where an adult patient with DCRV incidentally diagnosed after presentation with acute MI and had undergone successful coronary angioplasty.
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Affiliation(s)
- Ravindranath K Shankarappa
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka, India
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41
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Loukas M, Housman B, Blaak C, Kralovic S, Tubbs RS, Anderson RH. Double-chambered right ventricle: a review. Cardiovasc Pathol 2013; 22:417-23. [PMID: 23701985 DOI: 10.1016/j.carpath.2013.03.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 03/16/2013] [Accepted: 03/18/2013] [Indexed: 11/19/2022] Open
Abstract
A double-chambered right ventricle is a rare heart defect in which the right ventricle is separated into a high-pressure proximal and low-pressure distal chamber. This defect is considered to be congenital and typically presents in infancy or childhood but has been reported to present rarely in adults. It can be caused by the presence of anomalous muscle tissue, hypertrophy of the endogenous trabecular bands, or an aberrant moderator band; all of which will typically result in progressive obstruction of the outflow tract. In this paper, we will discuss the general anatomy of the right ventricle, the relevant embryology of the heart, and the presentation, diagnosis, and treatment of a double-chambered right ventricle.
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Affiliation(s)
- Marios Loukas
- Department of Anatomical Sciences, School of Medicine, St George's University, Grenada, West Indies.
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42
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Chaurasia AS, Nawale JM, Yemul MA. Double-chambered right ventricle with pulmonary valve endocarditis. Echocardiography 2013; 30:E167-70. [PMID: 23551809 DOI: 10.1111/echo.12186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We describe a rare case of pulmonary valve endocarditis associated with a double-chambered right ventricle in an adolescent male highlighting the two-dimensional and three-dimensional transthoracic echocardiographic findings. He was managed with aggressive antibiotic therapy followed by surgery. The echocardiographic findings were confirmed during surgery.
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Affiliation(s)
- Ajay S Chaurasia
- Department of Cardiology, Topiwala National Medical College & B Y L Nair Charitable Hospital, Mumbai, India
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43
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Yabur-Espitia MR, Patiño-Bahena E, Cruz-Prieto B, Espinosa-Islas G, Espínola-Zavaleta N. [Presentation form and evolution of double-chambered right ventricle]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2013; 83:18-23. [PMID: 23422350 DOI: 10.1016/j.acmx.2012.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 12/19/2012] [Accepted: 12/28/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The double-chambered right ventricle (DCRV) is an uncommon congenital heart disease; it represents the 0,5% of these congenital cardiopathies. OBJECTIVE To describe the clinical and echocardiographic characteristics of a series of 11 patients. METHODS Eleven patients with DCRV were studied. A complete medical history, chest radiograph, electrocardiogram, and transthoracic echocardiography were performed. RESULTS The median age of studied patients was 10 years. The 36.45% of cases were asymptomatic and the diagnosis was made by echocardiography. Other cases had weakness during food in the lactancy stage and worsening of NYHA functional class in older children. The echocardiogram showed double-chambered right by a muscular band in all studied patients. The most frequent associated anomalies were: ventricular septal defect, patent foramen ovale, subvalvular aortic stenosis, and Fallot's Tetralogy. Seven patients went to surgical treatment and now 6 of them are in NYHA functional class i. CONCLUSIONS This paper has a special importance, because is the biggest series of patients with double-chambered right ventricle in Mexico and the results are comparable to the studies reported in the literature. The worsening of the NYHA functional class was the predominate symptom. The clinical manifestations can be presented from the lactancy to adulthood and the degree of obstruction could have a progressive character. The echocardiography is the method of choice in the diagnosis of these patients. The 91% of patients with DCRV who went to surgical treatment had excellent hemodynamic and functional results in the mid-follow-up.
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Affiliation(s)
- Mirna Rocío Yabur-Espitia
- Departamento de Ecocardiografía, Instituto Nacional de Cardiología Ignacio Chávez, México DF, México; Departamento de Pediatría, Hospital Pablo Tobón Uribe, Medellín, Colombia
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Gur DO, Gur O, Goksuluk H, Oral D. A case with double-chambered right ventricle and left ventricular-right atrial communication (Gerbode defect): potential pitfall for Eisenmenger syndrome. J Echocardiogr 2012; 10:106-8. [PMID: 27278211 DOI: 10.1007/s12574-012-0131-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 06/18/2012] [Accepted: 06/25/2012] [Indexed: 11/30/2022]
Abstract
The ventricular septal defect (VSD) can rarely be associated with other malformations such as double-chambered right ventricle (DCRV) in which hypertrophied muscle bundles divide the right ventricle into two chambers causing progressive obstruction (Mao et al., Asia Pac J Thorac Cardiovasc Surg 5:14-17, 1996). Most VSDs close spontaneously by apposition of the tricuspid leaflets, but the process is rarely disrupted, resulting in communication between left ventricle and right atrium called Gerbode defect [Cho et al., J Cardiovasc Ultrasound 19(3):148-151, 2011]. Hence, the Gerbode defect involves potential misinterpretation of its high-velocity shunt as pulmonary hypertension. Here we present a case with DCRV and Gerbode defect initially misdiagnosed to have Eisenmenger syndrome.
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Affiliation(s)
- Demet Ozkaramanli Gur
- Tekirdag State Hospital, Tekirdağ, Turkey. .,, Hurriyet Mah. Kar Sokak Royal Hill Sitesi A Blok D:9, Tekirdağ, Turkey.
| | - Ozcan Gur
- Department of Cardiovascular Surgery, Namık Kemal University, Tekirdağ, Turkey
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Arndt J, Werner P, Sleeper M. Primary infundibular stenosis and pedigree analysis in three Golden Retriever littermates. J Am Anim Hosp Assoc 2011; 48:50-3. [PMID: 22186718 DOI: 10.5326/jaaha-ms-5654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Three eight-week-old Golden Retriever puppy littermates were evaluated because of left basilar systolic murmurs and were diagnosed with primary infundibular stenosis. Pedigree analysis in this line was also performed to identify a mode of inheritance. All dogs were asymptomatic at the time of diagnosis; two of the three had congenital lesions in addition to primary infundibular stenosis. Two additional affected dogs were identified in the line, and pedigree analysis suggested an autosomal recessive mode of inheritance. Another, unrelated golden retriever was also identified with isolated infundibular stenosis in the record database. Primary infundibular stenosis should be considered in the differential diagnoses for golden retriever dogs with a left basilar systolic murmur, and is often associated with complex congenital cardiac disease. Primary infundibular stenosis may worsen in severity with time, and in this line of dogs an autosomal recessive pattern of inheritance is likely.
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Affiliation(s)
- Jason Arndt
- Section of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA.
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46
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Park JG, Ryu HJ, Jung YS, Kim KJ, Lee BR, Jung BC, Kang H. Isolated double-chambered right ventricle in a young adult. Korean Circ J 2011; 41:272-5. [PMID: 21731569 PMCID: PMC3116106 DOI: 10.4070/kcj.2011.41.5.272] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 08/20/2010] [Accepted: 09/27/2010] [Indexed: 11/24/2022] Open
Abstract
Double-chambered right ventricle (DCRV) is a rare congenital heart disorder in which the right ventricle is divided by an anomalous muscle bundle into a high pressure inlet portion and a low pressure outlet portion. We report a case of isolated DCRV without symptoms in adulthood, diagnosed through echocardiography, cardiac catheterization and cardiac magnetic resonance imaging.
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Affiliation(s)
- Jung-Gil Park
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
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FUKUSHIMA R, TANAKA R, SUZUKI S, HAMABE R, MACHIDA N, NAKAO S, SAIDA Y, TAKASHIMA K, MATSUMOTO H, KOYAMA H, HIROSE H, YAMANE Y. Epidemiological and Morphological Studies of Double-Chambered Right Ventricle in Dogs. J Vet Med Sci 2011; 73:1287-93. [DOI: 10.1292/jvms.10-0485] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ryuji FUKUSHIMA
- Department of Veterinary Surgery, Faculty of Agriculture, Tokyo University of Agriculture and Technology
| | - Ryou TANAKA
- Department of Veterinary Surgery, Faculty of Agriculture, Tokyo University of Agriculture and Technology
| | - Shuji SUZUKI
- Department of Veterinary Surgery, Faculty of Agriculture, Tokyo University of Agriculture and Technology
| | - Rina HAMABE
- Department of Veterinary Surgery, Faculty of Agriculture, Tokyo University of Agriculture and Technology
| | - Noboru MACHIDA
- Department of Veterinary Clinical Oncology, Faculty of Agriculture, Tokyo University of Agriculture and Technology
| | - Shu NAKAO
- Department of Veterinary Clinical Oncology, Faculty of Agriculture, Tokyo University of Agriculture and Technology
| | | | | | - Hirotaka MATSUMOTO
- Department of Veterinary Internal Medicine, Faculty of Veterinary, Nippon Veterinary and Life Science University
| | - Hidekazu KOYAMA
- Department of Veterinary Internal Medicine, Faculty of Veterinary, Nippon Veterinary and Life Science University
| | - Hisashi HIROSE
- Department of Veterinary Internal Medicine, Faculty of Veterinary, Nippon Veterinary and Life Science University
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Darwazah AK, Eida M, Bader V, Khalil M. Surgical management of double-chambered right ventricle in adults. Tex Heart Inst J 2011; 38:301-304. [PMID: 21720479 PMCID: PMC3113143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Double-chambered right ventricle is a congenital anomaly in which the right ventricle is divided into 2 portions by anomalous muscle bundles. These cases often present in children, but rarely in adults. We discuss 2 cases of double-chambered right ventricle, in patients aged 42 and 35 years. When cases remain asymptomatic until adulthood, they can present with unusual symptoms that lead to incorrect diagnosis. Our cases represent 2 very different manifestations of double-chambered right ventricle, which differ in presentation, in the site of abnormal obstructive muscle bundles, and in the presence of associated lesions. Both of our patients underwent successful surgical resection of the obstruction. One patient also underwent closure of a ventricular septal defect. We also review the literature on the various mechanisms that have been proposed to account for the complex morphology of the abnormal muscle bundles.
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Affiliation(s)
- Ahmad K Darwazah
- Department of Cardiac Surgery, Ramallah Hospital, West Bank, Ramallah, Israel.
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Nacif MS, Santos TCDCRSD, Huang J, Lucas E, Sibley CT, Santos AASMDD. Qual o seu diagnóstico? Radiol Bras 2010. [DOI: 10.1590/s0100-39842010000400002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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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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