Double Outlet Right Ventricle with Non-Committed Ventricular Septal Defect and Other Complex Associated Anomalies in an Infant: Overview of the Surgical Management Approach


Authors : Triani Dhamayanti; Yulius Patimang; Andi Alief Utama Armin; Muzakkir Amir

Volume/Issue : Volume 9 - 2024, Issue 5 - May

Google Scholar : https://tinyurl.com/mujbwm7d

Scribd : https://tinyurl.com/2nvmuvy6

DOI : https://doi.org/10.38124/ijisrt/IJISRT24MAY990

Abstract : In the first place, the right ventricle is the primary or only point of origin for both main arteries in a patient with double outlet right ventricle (DORV). In order to guarantee proper repair, a wide variety of surgical approaches, considerations, and procedures are required for the wide spectrum of disorders that make up DORV. A functional classification based on physiological characteristics is one technique to classifying it, which might help determine the appropriate surgical strategy. Presentation of the case: Our case study focused on a female newborn infant who was 2 months old when she arrived at the hospital complaining of worsening shortness of breath and anorexia. The patient was diagnosed with pulmonary over-circulation, an abnormal accumulation of blood flowing into the lungs, through the following cardiac abnormalities: double outlet right ventricle (DORV) with a non-committal ventricular septal defect (VSD), no pulmonary stenosis (PS), mitral atresia, atrial septal defect (ASD), single ventricle dominance (SVD), anomalous pulmonary venous drainage (APVD), and patent ductus arteriosus (PDA). After a palliative procedure including the closure of the PDA and the implantation of a PA band, the patient was to have a surgical procedure known as univentricular repair. During the surgical meeting, this course of action was agreed upon. Conclusion: Different atrial configurations, atrioventricular connections, ventricular morphologies, and spatial interactions between the main arteries may all contribute to the wide anatomical spectrum of DORV. In order to decide between biventricular repair and univentricular palliation, several anatomical features must be present in the patient. In addition, palliative treatments may be necessary for certain patients before they may have a permanent surgical repair.

Keywords : Double Outlet Right Ventricle (DORV); Univentricular repair; Ventricular Septal Defect (VSD); Pulmonary over-circulation; Palliative treatment.

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In the first place, the right ventricle is the primary or only point of origin for both main arteries in a patient with double outlet right ventricle (DORV). In order to guarantee proper repair, a wide variety of surgical approaches, considerations, and procedures are required for the wide spectrum of disorders that make up DORV. A functional classification based on physiological characteristics is one technique to classifying it, which might help determine the appropriate surgical strategy. Presentation of the case: Our case study focused on a female newborn infant who was 2 months old when she arrived at the hospital complaining of worsening shortness of breath and anorexia. The patient was diagnosed with pulmonary over-circulation, an abnormal accumulation of blood flowing into the lungs, through the following cardiac abnormalities: double outlet right ventricle (DORV) with a non-committal ventricular septal defect (VSD), no pulmonary stenosis (PS), mitral atresia, atrial septal defect (ASD), single ventricle dominance (SVD), anomalous pulmonary venous drainage (APVD), and patent ductus arteriosus (PDA). After a palliative procedure including the closure of the PDA and the implantation of a PA band, the patient was to have a surgical procedure known as univentricular repair. During the surgical meeting, this course of action was agreed upon. Conclusion: Different atrial configurations, atrioventricular connections, ventricular morphologies, and spatial interactions between the main arteries may all contribute to the wide anatomical spectrum of DORV. In order to decide between biventricular repair and univentricular palliation, several anatomical features must be present in the patient. In addition, palliative treatments may be necessary for certain patients before they may have a permanent surgical repair.

Keywords : Double Outlet Right Ventricle (DORV); Univentricular repair; Ventricular Septal Defect (VSD); Pulmonary over-circulation; Palliative treatment.

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