Double Outlet Right Ventricle

From the 4 chamber view it is obvious that this heart is not normal. The atrio-ventricular valve leaflets do not appear to show two normal mitral and tricuspid valves

If you're not sure, compare the image above to a normal 4 chamber view:

Using colour Doppler it appears that both ventricles are filling from a single atrium.

And examining the outflow tracts both again seem to come from the right ventricle. In this case the outflow tract to the left of the screen (in blue) shows relatively laminar flow, the second tract to the right shows turbulent flow (in orange).

Again, in our view neonatal echocardiographers should be focussed on appreciating normality (and abnormality) rather than precisely delineating the exact structural nature of a lesion. In this child for example, if the presentation was cyanosis after birth, management should be initiation of a prostglandin infusion, and urgent discussion with a cardiologist, rather than prolonged attempts to describe a complex abnormal morphology.

Copyright December © 2011 All rights reserved.

Contributors: Dr Alan Groves & Govindpal S Kooner