Abstract
Objective. To establish links between the degree of embryological truncal rotation, development of different double-outlet right ventricle (DORV) types and the course of the arterial trunks by means of computed morphometry.
Material and methods. Seventy-five patients diagnosed with DORV undergone computed tomography-angiography. Depending on the location of VSD all patients were divided into the subaortic (n=32), subpulmonary (n=17), subarterial (n=6), noncommitted (n=13) and not directly committed (n=7) groups. Truncal rotation degree was determined based on the angle measured between the arterial trunks' and frontal axes.
Results. Using computed tomography the following results of the degree of the truncal rotation were obtained: in subaortic group – 28±3 (23–34)°, in subpulmonary group – 0 (–68, 10)°, in subarterial group – 16±9 (4–28)°, in noncommitted group – 4 (–5, 10)°, in not directly committed – 7±5 (0–13)°. Spiral course of the arterial trunks was seen in patients with subaortic and subarterial defect, while parallel course in groups with subpulmonary, subarterial, noncommitted, and not directly committed defects.
Conclusions. Different morphologic types of DORV represent a single spectrum of anomalies developing as a result of the common pathologic process and differing in the degree of the rotation according to which they may be represented in the following order: DORV with subpulmonary defect, DORV with subarterial defect and hypertrophied conal septum, DORV with subaortic defect. DORV with subarterial defect may exist in two variants depending on the presence or absence on conal septum. Twisting of the arterial trunks occurs as a result of the truncal rotation to the right.
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About the authors
- Konstantin V. Shatalov, Dr. Med. Sci., Professor, Head of Department; ORCID
- Konstantine M. Dzhidzhikhiya, Cand. Med. Sci., Cardiac Surgeon; ORCID
