Value of a novel categorization of congenital double-outlet right ventricle on guiding the choice of surgical approaches
10.3760/cma.j.issn.0253-3758.2015.11.010
- VernacularTitle:先天性右心室双出口的新分型方法及其对术式选择的指导作用
- Author:
Kunjing PANG
1
;
Hong MENG
;
Hao WANG
;
Shengshou HU
;
Zhongdong HUA
;
Xiangbin PAN
;
Shoujun LI
Author Information
1. 100037,中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院超声科
- Keywords:
Cardiovascular abnormalities;
Echocardiography;
Surgical procedures,operative
- From:
Chinese Journal of Cardiology
2015;43(11):969-974
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility and value of a new categorization of double outlet right ventricular (DORV) on guiding the optimal choices of surgical approaches.Methods Five hundred and twenty one DORV patients diagnosed by echocardiography,angiocardiography and CT at Fuwai Hospital from May 2003 to September 2014 were enrolled in this retrospective study.Congenital DORV was categorized according to three basic factors as follows:the positional relationships of great arteries (normal relation or abnormal relation),the relationships of the ventricular septal defect (VSD) to the great arteries (committed VSD or remote VSD),the presence or absence of pulmonary outflow tract obstruction (POTO).Eight types of DORV were established:type Ⅰ (normal relation,committed VSD,without POTO),type Ⅱ (normal relation,committed VSD,POTO),type Ⅲ (normal relation,remote VSD,without POTO),type Ⅳ (normal relation,remote VSD,POTO),type Ⅴ (abnormal relation,committed VSD,without POTO),type Ⅵ (abnormal relation,committed VSD,POTO),type Ⅶ (abnormal relation,remote VSD,without POTO),type Ⅷ (abnormal relation,remote VSD,POTO).Feasibility of this classification and the value of this classification on guiding the choice of surgical approaches were analyzed.Results Among the five hundred and twenty one patients,there were 90 patients (17.3％) with type Ⅰ DORV,94 patients (18.0％) with type Ⅱ,33 patients (6.3％) with type Ⅲ,34 patients (6.5％) with type Ⅳ,64 patients (12.3％) with type Ⅴ,61 patients (11.7％) with type Ⅵ,33 patients (6.3％) with type Ⅶ,112 patients (21.5％) with type Ⅷ.Thus,all patients could be typed by this classification method.The echocardiography diagnosis was consistent with the intra-operative and or cardiac catheterization/CT findings.Excluding the contraindications of bi-ventricular repair,different surgical approaches were performed in every subtype of DORV according the classification,which indicated that this novel categorization could accurately guide the clinic managements.Conclusion This novel DORV categorization can accurately diagnose DORV lesions,and guide the clinic therapy choice.
