2. Double Outlet Right Ventricle (DORV)
DORV is a congenital heart defect in which both
the aorta and pulmonary artery exit from the right
ventricle. No arteries arise from the LV.
Aorta carries deoxygenated blood from the RV to
the various parts of the body
DORV includes a VSD, pulmonary stenosis or
TGA may also be part of the defect
3. Types
DORV occurs in multiple forms, with
variability of great artery position and size as well
as of VSD location.
The clinical manifestations are similarly
variable, depending on how the anatomical
defects affect the physiology of the heart, in
terms of altering the normal flow of blood from
the RV and LV to the aorta & pulmonary artery.
4. In DORV with a subaortic VSD, blood from
the LV flows through the VSD to the aorta &
blood from the RV flows mainly to the
pulmonary artery, yielding physiology similar to
Tetrology of Fallot.
In DORV with a subpulmonic VSD,(called
Taussig-Bing syndrome), blood from the
LV flows through the VSD to the pulmonary
artery and blood from the RV flows mainly to
the aorta , yielding physiology similar to
Transposition of Great Arteries.
5. But if there is pulmonic stenosis in
addition, physiology resembles Tetrology of
Fallot
In other forms of DORV, blood from both
ventricles is substantially mixed in the RV,
yielding physiology that resembles a large VSD
But again, if there is pulmonic stenosis,
physiology resembles Tetrology of Fallot.
6. Treatment
Total corrective surgery is the definite treatment
Surgical repair includes correction of pulmonary
stenosis if present & patch closure of the VSD,
placed in such a way as to direct blood flow from
the left ventricle to the aorta.
Palliative surgery
