• Journal of Chest Surgery
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• v.12 no.2
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• pp.119-126
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• 1979

This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1242-1246
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• 1997

Criss-cross heart which is a cardiac malformation caused by abnormal rotation of the ventricles early in embryonic development, is rare but a double outlet of right ventricle in priss-cross heart is very rare. We experienced a case of criss-cross heart which is situs solidus, concordant atrioventricular connection and double outlet of rig t ventricle with remote ventricular septal defect of perimembranous inlet type. A 4-years old female was diagnosed as a double outlet of right ventricle in criss-cross heart after echocardiography, cardiac catheterization and cardiac angiography. The surgical correction was a intraventricular reconstruction of left ventricular outflow with 314 circle of 20 mm Hemashield vascular graft from the ventricular septal defect to the aorta. The patient had a temporary atrioventricular block but was recovered uneventfully, and a postoperative echocardiogram showed no left ventricular outflow obstruction, no intracardiac shunt.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.288-292
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• 1985

The division of the right ventricle into two chambers by aberrant muscle bands traversing the sinus portion, Double Chambered Right Ventricle[DCRV], is a relatively rare congenital cardiac malformation. Double Outlet Right Ventricle[DORV], basically recognized by the origin of both great arteries from the morphologic right ventricle, is also a rare anomaly; its frequency has been reported as approximately 0.09 case per 1,000 birth. DORV associated with DCRV, unusual combination, is even more rare; only a few known cases have been recorded previously in the literature. This report presents our surgical experience with this rare anomaly, DORV with DCRV.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1471-1475
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• 1992

Within the group of congenital cardiac anomalies manifesting atrioventricular discordance, there exists a subset of hearts characterized by the additional presence of double outlet of the morphological right ventricle. Most of these hearts have associated pulmonary stenosis and abnormal direction of the cardiac apex, and all have a ventricular septal defect. Recently, a 10-year old boy underwent successful surgical correction of double outlet right ventricle with atrioventricular discordance. Diagnostic confirmation was made by 2-D echocardiography, cardiac catheterization and cineangiocardiography. The operation consisted of patch closure of ventricular septal defect so as to leave both great arteries draining the systemic[morphologically right] ventricle, and insertion of an extracardiac valved conduit between the morphological left ventricle and the distal end of the proximally oversewn pulmonary artery. Postoperative course was uneventful.

• Journal of Veterinary Clinics
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• v.33 no.5
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• pp.307-309
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• 2016

A 10-month-old intact male Scottish Fold was presented with cardiomegaly. The cat showed exercise intolerance after birth. Radiographs showed cardiomegaly with bulging of the main pulmonary artery and dilation of pulmonary arteries. Echocardiogram revealed abnormally arisen aortic root toward right ventricle with left-to-right shunted perimembraneous ventricular septal defect located underneath the aortic root. Based on imaging studies, the cat was diagnosed as subaortic type of double outlet right ventricle (DORV) without concurrent abnormalities.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.225-232
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• 1979

A 15-year-old girl underwent successful surgical correction of double-outlet right ventricle [S.D.L.] subaortic ventricular septal defect, patent foramen ovale, and pulmonary hypoplasia with valvular stenosis. The operation consisted of an internal baffling connecting the left ventricle to the aorta through the ventricular septal defect. The pulmonary stenosis was corrected with the method of connection the right ventricle to the pulmonary artery bifurcation using the Hancock valve[18mm] contained conduit. This rare type of DORV seemed to be suitable for corrective surgery, and the patient`s condition is very good until present time (post operative 7 months).

• Journal of Chest Surgery
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• v.14 no.2
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• pp.153-160
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• 1981

Within the group of congenital cardiac anomalies manifesting dextrocardia and double-outlet right ventricle, ventricular non-inversion [S.D.L] is extremely rare. Recently, a 5 year-old boy underwent a successful surgical correction of dextrocardia associated with double-outlet right ventricle, ventricular non-inversion [S.D], ventricular septal defect, pulmonary stenosis, and patent foramen ovale. The operation consisted of construction of an internal baffle connecting the left ventricle to the aorta through the large ventricular septal defect [subaortic]. The pulmonary stenosis was managed by infundibulectomy and patch enlargement of the right ventricular wall. The patient`s postoperative recovery has been uneventful, and 2 months after the operation, he is doing well.

• Journal of Chest Surgery
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• v.12 no.4
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• pp.346-349
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• 1979

We have recently operated 6 year-old male patient who had double outlet right ventricle with dextrocardia, situs inversus, pulmonary stenosis and 2 ventricular septal defects. Rastelli operation was performed by internal baffling with Cooley woven Dacron and tunnel grafting with Hancock valved conduit between the right ventricle and the main pulmonary artery.His postoperative course was uneventful. He was discharged in good conditions on P.O.D. #33.

• Journal of Chest Surgery
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• v.16 no.3
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• pp.349-355
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• 1983

Twenty-seven patients with double-outlet right ventricle underwent complete intracardiac repair between 1978 and 1983, June, at Seoul National University Hospital . Although definite aorto-mitral discontinuity was discovered in 20 patients, both great arteries arose wholly or mostly from the right ventricle in all cases. There were 17 cases with subaortic VSD, 6 with subpulmonic, 2 with doubly-committed, and 2 with non-committed VSD. Pulmonary stenosis was present in 21 patients. Intraventricular baffle repair was applied in 23 patients. Three patients required extracardiac conduit to establish continuity between right ventricle and pulmonary artery, and modified Fontan operation was performed in one patient. Over-all mortality rate was 37.0%, but recently 4 of 15 died [26.7%]. One late death occurred from infective endocarditis. Incremental risk factors were small patient size, subpulmonic or non-committed VSD, presence of PS, coronary artery anomalies, associated valvular lesion and other complicated anomalies. However, great artery relationship, restrictive VSD and transannular patch were not risk factors. No instances of complete heart block occurred. Of the survivors, all showed complete or in complete right bundle branch block and in one patient intermittent ventricular tachycardia had developed. The important cause of death was low cardiac output syndrome.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.326-333
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• 1988

The results of surgical experience of double outlet right ventricle with pulmonic stenosis in 14 patients are reported. Among the 14 patients, 8 underwent the intraventricular tunnel repair with the result of 3 hospital deaths, 5 had Fontan type operations due to the various anatomic reasons and resulted in one hospital death, and the remaining one patient had palliative pulmonary valvotomy. Besides the problems related to the effective relief of the pulmonic stenosis, double outlet right ventricle with pulmonic stenosis may present a surgical challenge because severe associated anomalies which definitely complicate their repair are not uncommon. We describe the anatomic details of our 14 cases of DORV with PS and the surgical results. The results having been unsatisfactory, more meticulous diagnostic studies for the detailed intracardiac morphologies and the strict indication for their repair with the refinement of surgical technique seem necessary for the better surgical results.