Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-25T02:38:40.507Z Has data issue: false hasContentIssue false

The anatomy of hearts with double inlet ventricle

Published online by Cambridge University Press:  10 January 2006

Andrew C. Cook
Affiliation:
Cardiac Unit, Institute of Child Health, University College, London, United Kingdom
Robert H. Anderson
Affiliation:
Cardiac Unit, Institute of Child Health, University College, London, United Kingdom

Extract

In the past, hearts with double inlet ventricle have been amongst the most contentious of congenital cardiac malformations. This is because, although most examples found with this particular atrioventricular connection have one big and one small chamber within the ventricular mass, for many years the variant most frequently encountered, with a dominant left ventricle, was usually described as exhibiting a single ventricle.1 With the recognition that, in this particular variant, the small chamber is an incomplete right ventricle, and is never capable of supporting independently the pulmonary circulation, the anatomic situation has now been clarified, as explained in the previous review,2 by recognising that the arrangement produces a functionally single ventricle, and that almost always patients with this lesion, if treated surgically, will be converted to the Fontan circulation. Even though, nonetheless, most patients with all variants of double inlet ventricle will likely end up with the Fontan circulation, it remains necessary to identify the functionally significant variants, namely those to be found in ventricular morphology, atrioventricular valvar morphology, ventriculo-arterial connections, and associated malformations.3

Type
Research Article
Copyright
© 2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Van Praagh R, Ongley PA, Swan HJC. Anatomic type of single or common ventricle in man. Morphologic and geometric aspects of 60 necropsied cases. Am J Cardiol 1964; 13: 367386.Google Scholar
Jacobs M, Anderson RH. Nomenclature of the functionally univentricular heart. Cardiol Young 2006; 38.Google Scholar
Cook AC, Anderson RH. The functionally univentricular circulation: anatomic substrates as related to function. Cardiol Young 2005; 15 (Suppl 3): 716.Google Scholar
Franklin RCG, Spiegelhalter DJ, Anderson RH, et al. Double-inlet ventricle presenting in infancy. I. Survival without definitive repair. J Thorac Cardiovasc Surg 1991; 101: 767776.Google Scholar
Doherty A, Ho SY, Anderson RH, Rigby ML. The morphological nature of the atrioventricular valves in hearts with double inlet left ventricle. Pediatr Pathol 1989; 9: 521529.Google Scholar
Milo S, Ho SY, Macartney FJ, et al. Straddling and overriding atrioventricular valves morphology and classification. Am J Cardiol 1979; 44: 11221134.Google Scholar
Wilkinson JL, Anderson RH, Arnold R, Hamilton DI, Smith A. The conducting tissues in primitive ventricular hearts without an outlet chamber. Circulation 1976; 53: 930938.Google Scholar
Deanfield JD, Tommasini G, Anderson RH, Macartney FJ. Tricuspid atresia: analysis of coronary artery distribution and ventricular morphology. Br Heart J 1982; 48: 485492.Google Scholar
Uemura H, Yagihara T. Ventricular septation in patients with double inlet left ventricle. In: Redington AN, Brawn WJ, Deanfield JE, Anderson RH (eds). The Right Heart in Congenital Heart Disease. Greenwich Medical Media, London, 1998, pp 163167.
Edwards JE. Discussion. In: Davila JC (ed.). 2nd Henry Ford Hospital International Symposium on Cardiac Surgery. Appleton-Century-Crofts, NY, 1977, p 242.
Fyler DC. Single ventricle. In: Nadas' Pediatric Cardiology. Mosby-Year Book, St Louis, 1992, pp 649658.
Anderson RH, Becker AE, Tynan M, Macartney FJ, Rigby ML, Wilkinson JL. The univentricular atrioventricular connection: getting to the root of a thorny problem. Am J Cardiol 1984; 54: 822828.Google Scholar
Bevilacqua M, Sanders SP, Van Praagh S, Colan SD, Parness I. Double-inlet single left ventricle: echocardiographic anatomy with emphasis on the morphology of the atrioventricular valves and ventricular septal defect. J Am Coll Cardiol 1991; 18: 559568.Google Scholar
Hosseinpour AR, Anderson RH, Ho SY. The anatomy of the septal perforating arteries in normal and congenitally malformed hearts. J Thorac Cardiovasc Surg 2001; 121: 10461052.Google Scholar
Cheung HC, Lincoln C, Anderson RH, et al. Options for surgical repair in hearts with univentricular atrioventricular connection and subaortic stenosis. J Thorac Cardiovasc Surg 1990; 100: 672681.Google Scholar