![]() In DORV, the one great artery and more than half of the other, the so-called “50% rule,” originates from the morphologic RV. In this article, a wide spectrum of cardiac anatomy in DORV is systematically described based on a literature review and single-center experience over 20 years using 3D cardiac CT data. ![]() In particular, the transparent-lumen volume or cinematic rendering technique is useful for demonstrating intracardiacs anatomy and is therefore suitable for assessing anatomical details of DORV. In contrast, the volume rendering technique used for 3D illustration of cardiac CT provides high-fidelity reproduction of cardiac anatomy. In addition, cardiac walls in hollow models usually do not replicate true anatomy, but they are commonly just outlines of cast models. A substantial amount of information, including material density and fine spatial details, must be lost from the original data. However, 3D virtual heart models used for advanced visualization are a type of shaded surface rending technique. Because the quality of source images determines the quality of 3D-printed heart models, cardiac CT is the most commonly used imaging modality in 3D printing for congenital heart disease. Three-dimensional (3D) printing technology has recently been used to characterize the morphologic details of DORV. However, cardiac MRI is limited in evaluating cardiac anatomic details due to low spatial resolution, and lengthy examination is disadvantageous, especially in young pediatric patients requiring sedation or general anesthesia.Ĭardiac MRI has been subsequently performed using cardiac CT, which offers higher image quality and accessibility due to high spatial resolution and short scan time. Cardiac MRI has been used to elucidate the anatomical details of DORV with VSD. Therefore, DORV may hemodynamically mimic ventricular septal defect (VSD), tetralogy of Fallot (TOF), transposition of the great arteries (TGA), and functional single ventricle. Unlike the simple definition, the anatomic spectrum of this anomaly is enormously diverse in association with any atrial arrangement, atrioventricular connection, ventricular morphology, and spatial relationship between both great arteries. ![]() In addition, the surgical procedures available for these patients and major postoperative complications are described.ĭouble outlet right ventricle (DORV) is a type of abnormal ventriculoarterial connection in which both great arteries are connected completely or predominantly to the morphologic RV. In this pictorial essay, major anatomic factors affecting surgical decision-making in DORV with ventricular septal defects were comprehensively reviewed using three-dimensional cardiac CT data. Due to high spatial and contrast resolutions, cardiac CT can provide an accurate characterization of various intracardiac morphologic features of DORV. Because different surgical strategies are applied to different subtypes of DORV with ventricular septal defects, a detailed assessment of intracardiac anatomy should be performed preoperatively. Unlike other congenital heart diseases, DORV demonstrates various anatomic and hemodynamic subtypes, mimicking ventricular septal defect, tetralogy of Fallot, transposition of the great arteries, and functional single ventricle. Double outlet right ventricle (DORV) is a relatively common congenital heart disease in which both great arteries are connected completely or predominantly to the morphologic RV. ![]()
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