All issues > Volume 27(10); 1984

Original Article

J Korean Pediatr Soc. 1984;27(10):982-990. Published online October 31, 1984.

Clinical and Hemodynamic Characteristics of Double Chambered Right Ventricle.

Seok Chol Jeon¹, Seung Ro Lee¹, Heung Seok Seo¹, Sam Hyun Kim², Hurn Chae², Kun Ho Kim², Seung Jae Yang³, Hahng Lee³, Heung Jae Lee³

¹Dept. of Radiology College of Medicine, Hanyang University
²Dept. of Pediatrics College of Medicine, Hanyang University
³Dept. of Thoracic surgery College of Medicine, Hanyang University

Abstract

During the period from May 1981 to Feb. 1984, authors experienced 15 cases of double chambered right ventricle (D.C.R.V.) at Hanyang University Hospital. Among these 15 cases of D.C.R.V., 13 cases were confirmed by open heart surgery. We analysed the physical characteristics and echocardiographic, cardiac catheterization, angiographic and operative findings. Results are as follows; 1) Authors observations suggest that right ventricular obstructing lesions in patients with D.C.R.V. is not moderator band, but aberrant muscle bundle. 2)Scrutinizing the findings and the characteristics of various clinical manifestations and echocardiogram, it was possible to suspect intracavitary obstructive lesion in 8 cases among 15 cases of confirmed D.C.R.V. before performing cardiac catheterization and angiography. 3)In most of the cases, variable intracavitary pressure gradient in right ventricular chamber was demonstrable during cardiac catheterization, but it was not an essential feature in early mild form D.C.R.V. 4)Most reliable diagnostic feature of D.C.R.V. before surgery was the filling defect of aberrant muscle bundle on right ventriculogram. 5) Significant 的rial change in physical characteristics, E.K.G. and chest X-ray findings were observed in two cases who were followed up for over 4 years before surgery. Moreover definite development of a large pressure gradient over 4 years period was emonstrable on follow up cardiac catheterization in one case. Therefore it is highly suggested that right ventricular obstruction in D.C.R.V. progresses with time. 6)Surgical repair were performed in 13 cases without perioperative mortality, and no significant post-operative complications such as conduction abnormalities were observed after excision of aberrant muscle bundle. 7) From the view point of the progressive nature of R.V. obstruction in D.C.R.V. and the low risk of perioperative procedure, we recommend early surgical repair in cases with D.C.R.V.

Keywords :Double chambered right ventricle (D. C. R. V.); Aberrant muscle bundle;Right ventriculogram;Hemodynamics