Double-outlet right ventricle. A clinical-roentgenologic-pathologic study of 28 consecutive patients.

Twenty-eight cases of double-outlet right ventricle (DORV) were found from 1975 to 1980 in the Shanghai Chest Hospital. On plain films, four types of abnormal heart configuration were found: mitral, boot-shaped, atypical, and bizarre. The main angiocardiographic findings were: (1) simultaneous visualization of aorta and pulmonary artery on right ventriculography, both arising from the right ventricle; (2) D- or L-type of aortic transposition in most; (3) the two semilunar valves at approximately the same horizontal level; (4) an infundibulum present below the semilunar valve; (5) ventricular septal defect; and (6) associated pulmonary stenosis and/or other anomalies. An anatomic-radiologic classification was suggested and based chiefly on symbolic representation of segmental combinations including visceral trial situs, type of cardiac loop, relation between the semilunar valves, presence or absence of pulmonary stenosis and whether the ventricular septal defect was subpulmonary or not. The findings substantiated the viewpoint that in DORV there exists on embryologic and pathologic ground transitional changes ranging from those closely resembling tetralogy of Fallot to complete transposition of the great vessels.