All issues > Volume 38(7); 1995

Original Article

J Korean Pediatr Soc. 1995;38(7):914-921. Published online July 15, 1995.

Double Chambered Right Ventricle-Review of Clinical Findings

Jin Young JY Song¹, Jun Tac JT Ko¹, Ho Sung HS Kim¹, Jung Il JI Rho¹, Jung Yeun JY Choi¹, Yong Soo YS Yun¹

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea

Abstract

Purpose
: The DCRV is a cardiac anomaly in which the right ventricle is divided into two dif-ferent pressure chambers by aberrant hypertrophied muscle bundles arising from the lower infundibular septal region. DCRV may be associated with other congenital cardiac anomalies and surgical treatment is required because we know that this obstruction is progressive. In this report, we reviewed clinically a lot of cases of DCRV for the purpose of offering strategies of diagnosis, treatment and further follow up.
Methods
: This is a retrospective report of clinical study on the 65 patients of DCRV in oper-ative findings who were hospitalized at the Seoul National University Children Hospital during the period between the 1st. April of 1986 and the 30th. June of 1994
Results
: 1) 65 patients( 1.08%) of 5992 patients undergone open heart surgeries were DCRV in which 40 patients(61.5%) were male and 25 patients(38.5%) were female. 2) Various cardiac anomalies were associated with DCRV. The most common were VSD (95.4%), which was usually perimembranous(16.9%), and pulmonary stenosis (18.5%). 3) Many patients with DCRV and VSD had subaortic ridge or membrane.(24%) 4) The initial diagnostic method were echocardiography(35.4%), cardiac cath and angiography(27.7%) and other 36% of patients with DCRV were detected at operation. 5) The time of operation was closely related to the time of diagnosis and operation was done as soon as diagnosed. 6) The mean value of pressure difference between proximal and distal chamber in right ventricle was 31.0 24.02 mmHg (Mean SD) and related to patients' age at diagnosis. As the time for diagnosis delay, the pressure difference in right ventricle gets greater(p<0.05). 7) As for surgical repair, right atriotomy was most frequent method for approach 8) There were no significant postoperative complications except arrhythmia. 3 patients were reoperated during follow up period. Among them, two patients had recurrence of the DCRV after intial resection of abnormal muscle bundles and VSD closure and the other one patient had new obstructive lesion in right ventricle without previous DCRV history after the closure of simple ventricular septal defect.
Conclusion
: DCRV is the congenital heart anomaly that is usually combined with VSD or PS. So we must consider the possibility when we meet VSD ,esp. perimembranous, or PS for early diagnosis and treatment. Another important thing is the fact that VSD with LV outflow obstruction is highly susceptible to DCRV. In addition, there were a few cases of abnormal muscle bundle in RV with minimal pressure gradient which were found during operation, so operative findings were important for early resection of abnormal bundles in RV. Post-operative regular follow up was required because of recurrence.

Keywords :DCRV, Associated anomalies