Double outlet right ventricle

Double outlet right ventricle
Classification and external resources
Specialty	medical genetics
ICD-10	Q20.1
ICD-9-CM	745.11
OMIM	217095
DiseasesDB	32215
MedlinePlus	007328
eMedicine	ped/2509 ped/2508
MeSH	D004310

Double outlet right ventricle (DORV) is a form of congenital heart disease where both of the great arteries connect (in whole or in part) to the right ventricle (RV). In some cases it is found that this occurs on the left side of the heart rather than the right side.

Anatomy and pathophysiology

DORV occurs in multiple forms, with variability of great artery position and size, as well as of ventricular septal defect (VSD) location. It can occur with or without transposition of the great arteries. The clinical manifestations are similarly variable, depending on how the anatomical defects affect the physiology of the heart, in terms of altering the normal flow of blood from the RV and left ventricle (LV) to the aorta and pulmonary artery. For example:

in DORV with a subaortic VSD, blood from the LV flows through the VSD to the aorta and blood from the RV flows mainly to the pulmonary artery, yielding physiology similar to ventricular septal defect
in DORV with a subpulmonic VSD (called Taussig-Bing syndrome), blood from the LV flows through the VSD to the pulmonary artery and blood from the RV flows mainly to the aorta, yielding physiology similar to Transposition of the Great Arteries
- but if there is pulmonic stenosis in addition, physiology resembles Tetralogy of Fallot
in other forms of DORV, blood from both ventricles is substantially mixed in the RV, yielding physiology that resembles a large VSD
- but again, if there is pulmonic stenosis, physiology resembles Tetralogy of Fallot

Treatment

DORV is treated with surgery.

Epidemiology

DORV affects between 1% and 3% of people born with congenital heart defects.^[1]

Chromosomal abnormalities were reported in about 40% of reported cases in the medical literature.^[1]

References

1 2 Obler D, Juraszek AL, Smoot LB, Natowicz MR (August 2008). "Double outlet right ventricle: aetiologies and associations". J. Med. Genet. 45 (8): 481–97. doi:10.1136/jmg.2008.057984. PMID 18456715.

External links

Congenital heart defects (Q20–Q24, 745–746)

Cardiac shunt/
heart septal defect

Aortopulmonary septal defect	R→L: Double outlet right ventricle Taussig–Bing syndrome Transposition of the great vessels dextro levo Persistent truncus arteriosus Aortopulmonary window

Atrial septal defect	L→R: Sinus venosus atrial septal defect Lutembacher's syndrome

Ventricular septal defect	L→R and R→L: Eisenmenger's syndrome R→L, with other conditions: Tetralogy of Fallot

Atrioventricular septal defect	L→R: Ostium primum

Valvular heart disease/
heart chambers

Right	pulmonary valves stenosis insufficiency tricuspid valves stenosis atresia Ebstein's anomaly Hypoplastic right heart syndrome Uhl anomaly

Left	aortic valves stenosis insufficiency bicuspid mitral valves stenosis regurgitation Hypoplastic left heart syndrome

Other

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