右室雙出口英文

1、Double Outlet Right Ventricle(DORV),WEI NI,,,,1.with or without transposition of the great arteries2.ventricular septal defect(VSD)3.pulmonary hypertension or pulmonary stenosis (PH

2、 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)

3、And European Association for Cardio-Thoracic Surgery(EACTS）----2000,spatial relationship of the semilunar cusps in hearts with DORV,,Ⅰ . Great Arteries Relationship,D-malposition（12%）,L-malposition（5%）,,Parallel（29%）

4、,,,NormalAN,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%) n

5、on 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

6、a subpulmonary obstruction,subaortic VSD,VSD belows the aortic valveoverriding ＞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,

7、subpulmonary VSD,size in relation to the diameter of the pulmonary artery presence and severity of a subpulmonary obstruction,,VSD belows the pulmonary valveOverridingPH or PS,subpulmonary VSD,RV,RV,PA,PA,,,doubly Com

8、mitted VSD,VSD belows both the aorta and the pulmonary artery presence and severity of a subpulmonary obstruction,non-committed VSD,VSD is in a position away from the great arteries presence and severity of a subpulmo

9、nary obstruction subcostal coronal / 4 C views,LV,Ao,RV,LV,LV,RV,RV,AO,RV,AO,The type of DORV,According to:arterial interrelationship AN AA(TGA)location of VSD

10、 A-VSD N-VSDpulmonary hypertension or pulmonary stenosis PH PS,I AN A-VSD PH,AO,RV,LV,PA,AO,II AN A-VSD PS,AO,AO,PS,AO,LA,LA,III AN N-VSD PH,AO,

11、PA,PA,IV AN N-VSD PS,conal septum,,conal septum,,V AA A-VSD PH,VI AA A-VSD PS,PA,AO,VII AA N-VSD PH,VIII AA N-VSD PS,VIII AA N-VSD PS,semilunar valves side-by-side (AN) DORV with subpulmonary VSD (A-VS

12、D) no subpulmonary obstruction (no PS) semilunar valves and AV-valves separated by conal septum,,Taussig-Bing malformation ( special type),Summary,1.morphology and size of both ventricles and AV-valv

13、es2. arterial interrelationship3. Location of VSD and the diameter of arteries4. location and severity of a subpulmonary or subaotic obstruction,,,,,,Question,How can we distinguish DORV(II) from TOF?,DORV,TOF,,D

14、ORV,,DORV,,DORV,DORV,DORV(II),Conal septum,Next Content,1. physiopathology 2. clinical manifestation 3. surgical palliation and surgical repair,Reference book,Clinicl Echocardiography(P:680--703)Gui