右室双出口英文课件.ppt

Double Outlet Right Ventricle(DORV) WEI NI In a normal heart structure, the aorta connects to the left ventricle, In a normal heart structure: the aorta connects to the left ventricle the pulmonary artery connected to the right ventricle In a normal heart structure, the aorta connects to the left ventricle, In a normal heart structure: the aorta connects to the left ventricle the pulmonary artery connected to the right ventricle 1.with or without transposition of the great arteries 2.ventricular septal defect(VSD) 3.pulmonary hypertension or pulmonary stenosis (PH or PS) What if there are defects : Definition “DORV is a type of congenital heart disease which both great arteries arise either entirely or predominantly from the right ventricle” The Society of Thoracic Surgeons(STS) And European Association for Cardio-Thoracic Surgery(EACTS）----2000 100 % ＞50% spatial relationship of the semilunar cusps in hearts with DORV Ⅰ . Great Arteries Relationship D-malposition（12%） L-malposition（5%） Parallel（29%） Normal AN AA Ⅱ. Location of VSD Classification of the interventricular communication / VSD according to its location in relation to the great arteries subaortic (65%) subpulmonary (20-25%) doubly committed (3%) non committed (7%) A vast importance to surgical operation,rather than anatony or embryology size in relation to the diameter of the aorta distance between VSD and aortic valve(overriding ＞70%) presence and severity of a subpulmonary obstruction subaortic VSD VSD belows the aortic valve overriding ＞70% PH or PS subaortic VSD parasternal long axis Ao Ao LV LA RV RV Ao PA subaortic VSD with severe pulmonary stenosis subaortic VSD PA Ao subpulmonary VSD size in relation to the diameter of the pulmonary artery presence and severity of a subpulmonary obstruction VSD belows the pulmonary valve Overriding PH or PS subpulmonary VSD RV RV PA PA doubly Committed VSD VSD belows both