How is infantile right ventricular double exit caused?

summary

Double outlet right vessel refers to when two large vessels completely or nearly completely originate from the right ventricle. Recently, with the development of surgical techniques for double outlet right ventricle, its anatomical diagnostic criteria have been reevaluated. Although the "90% principle" rather than the "50% principle" is commonly used in clinical practice. However, it is easy to accurately judge the connection between the straddling great artery valve and the inferior ventricular septum in the study of pathological anatomy, so the diagnostic criteria is that when more than half of the peripheral roots of the two great arteries are connected to the same ventricle, it is diagnosed as double outlet right ventricle. Therefore, the double outlet of right ventricle can coexist with biventricular, univentricular or any large vessel and any type of atrioventricular connection. Let's share my experience with you.

How is infantile right ventricular double exit caused?

Because of the incomplete rotation of the conus trunk during embryonic development, it deviates from the contralateral connection of the left and right ventricles. The right dorsal and left ventral ridges fused to form two cones, anterolateral and posteromedial, which connected the trabecular primordium of the right ventricle. The posteromedial cone fused to the left ventricle and became its outflow tract.

The formation of double outlet of right ventricle is related to the abnormal rotation and absorption of conus. The relationship between the aorta and the pulmonary artery and the relationship between the semilunar valve depend on the development of the conus septum and the arterial trunk, respectively.

Sinus rhythm, right axis deviation and right ventricular hypertrophy were common manifestations. The QRS complex in the right precordial lead is often of QR type. The left ventricle is usually not enlarged. If there is obvious left ventricular enlargement, it may be associated with restrictive ventricular septal defect.

matters needing attention

Family history was inquired to understand the genetic status, and the influence of environmental factors was investigated to explore the etiology of congenital heart disease. Shaw investigated the address of pregnant women to find out the possible environmental teratogenic factors.