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2000, Number 2

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Arch Cardiol Mex 2000; 70 (2)

Double inlet left ventricle. Morphopathology and surgical anatomy

Muñoz CL, Ramírez S, Kuri NM, Salinas SHC

Language: Spanish
References: 31
Page: 136-147
PDF size: 917.63 Kb.


ABSTRACT

Because of the possibility of surgical treatment of double inlet left ventricle, its basic morphologic features of surgical and imagenological importance are analyzed. Seventeen hearts were studied with the segmental sequential system. The situs was solitus in thirteen; dextroisomerism in three and levoisomerism in one. The atrioventricular valves were separated in nine; there was a common atrioventricular valve in eight; stradding of the atrioventricular valve in seven and stenosis in two. The rudimentary right ventricle was to the right side in twelve hearts and to the left side in five. The discordant ventriculoarterial conexion was the most frequent (seven), followed by the concordant one (five) and double outlet right ventricle (five). There was pulmonary stenosis in five. The ventricular septum did not reach the crux cordis. The ventricular septal defect was bigger in straddling atrioventricular valves than in valves completely open intro the left ventricle, being restrictive in ventriculoarterial concordance. Surgical treatment varies as the complexity of this cardiopathy does, from cardiac septation to palliation procedures. The morphologic knowledge of this cardiac malformation is basic to interpret correctly the diagnostic imagenology.


REFERENCES

  1. Becker AE, Anderson RH: Pathology of congenital heart disease. Londres. Butterworths 1981; 241-256.

  2. Van Praagh R, Ongley PA, Swan HJC: Anatomic types of single or common ventricle in man, morphologic and geometric aspects of 68 necropsied cases. Am J Cardiol 1964; 13: 367-386.

  3. Lev M, Libertson RR, Kirkpatric JR, Eckner FAO, Arcilla RA: Single (primitive) ventricle. Circulation 1969; 39: 577-591.

  4. Anderson RH, Becker AE, Freedom RM, Quero-Jiménez M, Macartney FJ, Shinebourne EA, et al: Problems in the nomenclature of the univentricular heart. Herz 1979; 4: 97-102.

  5. Van Pragh R, Pleet JA, Van Pragh S: Single ventricle. Herz 1979; 4: 113-150.

  6. Anderson RH: Weasel words in paediatric cardiology. Single ventricle. Int J Cardiol 1983; 2: 425-429.

  7. De la Cruz MV, Miller BL: Double inlet left ventricle. Circulation 1968; 37: 249-260.

  8. Tynan MJ, Becker AE, Macartney FJ, Quero-Jiménez M, Shinebourne EA, Anderson RH: Nomenclature and classification of congenital heart disease. Br Heart J 1979; 41: 544-553.

  9. Muñoz-Castellanos L, De la Cruz MV, Cieslinsky A: Double inlet right ventricle: two pathological specimens with comments on embryology. Br Heart J 1973; 35: 292-297.

  10. Bankl H: Congenital malformations of the heart and great vessels. Baltimore. Urban & Schwarzenberg, 1977; 203-207.

  11. Perloff JK: The clinical recognition of congenital heart disease. Second Edition. Chapter 26. Toronto. Saunders, 1978: 641-662.

  12. Rigby ML, Anderson RH, Gibson D, Jones OD, Joseph MC, Shinebourne EA: Two-dimensional echocardiographic categorization of the univentricular heart. Ventricular morphology, type, and mode of atrioventricular connection. Br Heart J 1981; 46: 603-612.

  13. Freedom RM, Picchio F, Duncan WJ, Harder JR, Maes CAF, Rowe RD: The atrioventricular junction in the univentricular heart: A two-dimensional echocardiographic analysis. Pediatr Cardiol 1982; 3: 105-117.

  14. Huhta JC, Seward JB, Tajik AJ, Hagler DJ, Edwards WD: Two-Dimensional echocardiographic spectrum of univentricular atrioventricular connection. J Am Coll Cardiol 1985; 5: 149-175.

  15. Streeter GL: Developmental horizons in human embryos. Description of age group XIII, embryos about 4 or 5 millimeters long, and age group XIV, period of indentation of the lens vesicle. Carnegie Contribs to Embryol 1942; 541: 211-245.

  16. Streeter GL: Developmental horizons in human embryos. Description of age group XV, XVI, XVII and XVIII, being the third issue of a surgery of the Carnegie Collection. Carnegie Contribs to Embryol l948; 211: 133-203.

  17. Habeck JO, Reinhardt G, Findeisen V: A case of double inlet left ventricle in a 59-year-old man. Int J Cardiol 1991; 30(1): 119-120.

  18. Blalock A, Taussig HB: The surgical treatment of malformations of the heart in which there is pulmonary stenosis or pulmonary atresia. JAMA 1945; 128: 189-202.

  19. Nagashima M, Imai Y, Takanashi Y, Hoshino S, Seo K, Terada M, et al: Ventricular hypertrophy as a risk factor in ventricular septation for double-inlet left ventricle. Ann Thorac Surg 1997; 64: 3: 730-734.

  20. Mayer JE Jr, Bridges ND, Lock JE, Jonas RA, Castañeda AR: Factors associated with improved survival after modified Fontan operations. J Am Coll Cardiol 1991; 17: 33A-33A.

  21. Webber SA, Le Blanc JG, Keeton BR, Salmon AP, Sandor GG, Lamb RK, et al: Pulmonary artery banding is not contraindicated in double inlet left ventricle with transposition and aortic arch obstruction. Eur J Cardiothorac Surg 1995; 9: 515-520.

  22. Jensen RA Jr, Williams RG, Laks H, Drinkwater D, Kaplan S: Usefulness of banding of the pulmonary trunk with single ventricle physiology at risk for subaortic obstruction. Am J Cardiol 1996; 77(12): 1089-1093.

  23. McGoon DC, Danielson GK, Ritter DG, Wallace RB, Maloney JD, Marcelletti C. Correction of the univentricular heart having two atrioventricular valves. J Thorac Cardiovasc Surg 1977; 74: 218-226.

  24. Stefanelli G, Kirklin JW, Naftel DC, Blackstone EH, Pacifico AD, Kirklin JK et al: Early and intermediate-term (10-year) results of surgery for univentricular connection (“single ventricle”). Am J Cardiol 1984; 54: 811-821.

  25. Walsh T, Savage R, Hess DB: Successful pregnancy in a patient with a double inlet left ventricle treated with a septation procedure. South Med J 1990; 83: 3: 358-359.

  26. Anderson RH, Arnold T, Thaper MK, Jones RS, Hamilton DI: Cardiac specialized tissues in heart with an apparently single ventricular chamber (Double inlet left ventricle). Am J Cardiol 1974; 33: 95-106.

  27. Wenink ACG: The conduction tissues in primitive ventricle with outlet chamber: Two different possibilities. J Thorac Cardiovasc Surg 1978; 75: 747-753.

  28. Fontan RM, Baudet E: Surgical repair of tricuspid atresia. Thorax 1971; 26: 240-248.

  29. Kreutzer G, Galindez E, Bono H, De Palma C, Laura JPI: An operation for the correction of tricuspid atresia. J Thorac Cardiovasc Surg 1973; 66: 613-621.

  30. Franklin RC, Spiegelhalter DJ, Rossi Filho RI, Macartney FJ, Anderson RH, Rigby ML, et al. Double-inlet ventricle presenting in infancy. III. Outcome and potential for definitive repair. J Thorac Cardiovasc Surg 1991; 101: 924-934.

  31. Jonas RA, Castañeda AR, Lang P: Single ventricle (single-or double-inlet) complicated by subaortic stenosis: surgical options in infancy. Ann Thorac Surg 1985; 39: 362-366.




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