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Double Outlet Right Ventricle: Morphology and Function

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CT and MRI in Congenital Heart Diseases

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Abstract

Cross-sectional imaging with multislice CT (MSCT) or magnetic resonance (MR) is one of the mainstays of preoperative assessment of many complex congenital heart diseases (CHD) in current clinical practice, one of them is double outlet of right ventricle (DORV). DORV is a type of the conotruncal anomalies that encompasses a wide spectrum of anatomic malformations in which both the aorta and pulmonary arterial trunk arise entirely or predominantly from the morphological right ventricle (RV). The purpose of this chapter is to understand the spectrum of DORV and associated types of ventricular septal defect (VSD) on imaging.

Although echocardiography is considered as an initial imaging modality of choice, it is limited in the reliable assessment. Cross-sectional imaging help overcome the limitations of echocardiography and also avoid the complications of conventional angiography. It also provides excellent information about adjacent cardiovascular as well as extracardiac structures. Imaging specialists should be well versed with the complex morphology and physiology of DORV, as well as with various palliative and corrective surgical procedures performed in these patients.

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Author information

Authors and Affiliations

  1. U.N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India

    Megha M. Sheth & Yashpal Rana

  2. Department of Radiology, Amrita School of Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Ramiah Rajeshkannan

Authors
  1. Megha M. Sheth
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  2. Yashpal Rana
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  3. Ramiah Rajeshkannan
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Editor information

Editors and Affiliations

  1. Department of Radiology, Amrita School of Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Ramiah Rajeshkannan

  2. Department of Cardiothoracic imaging, Narayana Hrudayalaya, Bangalore, Karnataka, India

    Vimal Raj

  3. Department of Radiology, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India

    Sanjaya Viswamitra

1 Electronic Supplementary Material

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Videos 15.1 to 15.5

CMR in a 28 years old patient with DORV, left isomerism, sub aortic VSD, aneurysm of ascending aorta, sub aortic membrane (15.1 CMR report PDF 1329 kb)

Videos 15.6 to 15.12

CMR in a 17 years old girl showing Situs inversus, dextrocardia, DORV, severe infundibular and valvar PS, S/P BDGS (15.6 CMR report PDF 1601 kb)

Videos 15.13 to 15.19

CMR in 17 yrs old girl showing DORV, VSD (cono ventricular with superior inlet extension), Pulmonary stenosis. Status post bilateral BT shunts. Accessory mitral tissue and sub aortic conus along LV to aorta pathway (15.13 CMR report PDF 1281 kb)

Videos 15.20 to 15.24

CMR in 4 years old boy. AV discordance, DORV from the left sided RV, inlet VSD with conoventricular extension, straddling of mitral valve, severe PS. Status post BT shunt (15.20 CMR report PDF 840 kb)

Videos 15.25 to 15.32

CMR in 12 years old boy. Situs inversus, dextrocardia, interrupted IVC, bilateral SVC, complete AV canal defect, DORV with l-malposed great arteries arising from the left-sided morphological RV, severe valvar/subvalvar PS, right aortic arch. Status post bilateral BDGS (Kawashima) (15.25 CMR report PDF 1396 kb)

Videos 15.33 to 15.36

CMR in 6 years old boy. DORV, BDGS, Large CV VSD (inlet septum, extending into the subpulmonic area), Severe PS. Sub aortic conus along LV to aorta route (15.33 Full case report PAGES 180 kb)

Videos 15.37 to 15.44

CMR in 8 years old boy. DORV, conoventricular VSD with inlet extension, without PS. Status post PA banding, BDGS. LV-Aorta route occupied by tricuspid valve tissue and sub aortic conal tissue (15.37 CMR report PDF 851 kb)

Videos 15.45 to 15.54

CMR in 12 years old girl. S D L, DORV, large conoventricular VSD, anteriorly placed aorta. Status post PA banding, Right aortic arch and bilateral SVC. Tricuspid valve intrusion in LV-Ao path (15.45 CMR report PDF 42 kb)

Videos 15.55 to 15.58

CMR in 12 years old girl. S D L, DORV, large conoventricular VSD with bradycardia. S/P Extracardiac fenestrated Fontan (15.55 CMR report PDF 1726 kb)

Videos 15.59 to 15.64

CMR in 10 years old boy. DORV, malposed great arteries, non committed VSD. Status post Kawashima intraventricular tunnelling and fenestrated VSD closure. Subvalvar aortic stenosis resulting from indentation of VSD patch into LVOT and subaortic conus (15.59 CMR report PDF 638 kb)

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Sheth, M.M., Rana, Y., Rajeshkannan, R. (2021). Double Outlet Right Ventricle: Morphology and Function. In: Rajeshkannan, R., Raj, V., Viswamitra, S. (eds) CT and MRI in Congenital Heart Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-15-6755-1_15

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  • DOI: https://doi.org/10.1007/978-981-15-6755-1_15

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  • Online ISBN: 978-981-15-6755-1

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