Double outlet right ventricle - the 50% rule has always been about the conus.

IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-02-23 DOI:10.1097/HCO.0000000000001131
Rebecca Josowitz, Lindsay S Rogers
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Abstract

Purpose of review: There has been much variability in the definition of double outlet right ventricle (DORV) spanning the last century. Historically, emphasis has been placed on the assignment of the great arteries to the right ventricle as a definition of DORV. In this review, we aim to underscore the importance of conal muscle, rather than rules surrounding assignment of great arteries to ventricles. We will be outlining the variability in patient anatomy that results from variations in conal muscle development in DORV, which may not fit perfectly into predefined constructs. This anatomic variability directly determines physiology and surgical repair options.

Recent findings: There is a growing appreciation of the utility of cross-sectional imaging in complex DORV, and the generation of patient-specific 3D models with virtual reality simulations for surgical planning. These models improve the prediction of candidacy for biventricular repair and allow the mapping of complex baffle pathways preoperatively.

Summary: DORV is not a disease entity in itself, but rather a vast spectrum of disorders associated with maldevelopment of conal muscle and often abnormal expansion of one the great vessels. Patient-specific 3D models will be crucial for improved surgical planning and patient outcomes.

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双出口右心室--50% 规则一直与锥体有关。
综述的目的:在上个世纪,双出口右心室(DORV)的定义一直众说纷纭。从历史上看,DORV 的定义一直强调右心室大动脉的分配。在这篇综述中,我们旨在强调圆锥肌的重要性,而不是围绕大动脉与心室分配的规则。我们将概述由于 DORV 中锥肌发育的变化而导致的患者解剖结构的变异性,这种变异性可能无法完全符合预定义的结构。这种解剖变异直接决定了生理学和手术修复方案:最近的研究结果:越来越多的人认识到横断面成像在复杂 DORV 中的作用,以及通过虚拟现实模拟生成患者特异性三维模型用于手术规划。摘要:DORV本身并不是一种疾病,而是一种与锥体肌发育不良和大血管异常扩张有关的多种疾病。针对患者的三维模型对改进手术规划和患者预后至关重要。
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来源期刊
Current Opinion in Cardiology
Current Opinion in Cardiology 医学-心血管系统
CiteScore
4.20
自引率
4.30%
发文量
78
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.
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