In this section
In 'Double Outlet Right Ventricle' (DORV) the two Great Arteries
(Aorta and Pulmonary Artery) both originate from the right
ventricle and blood from the left ventricle passes across a VSD
into the RV to reach the great arteries. The lung circulation is
often exposed to very high pressure and increased blood flow (as
with a large VSD). There are many different varieties of this
The site of the VSD may vary and can affect the clinical
manifestations and the options for surgery. The illustration
below shows several variations.
The upper left diagram (1) shows an abnormality similar to Tetralogy
of Fallot, but without obstruction to flow to the lungs. Repair
involves placement of a patch within the right ventricle to direct
LV flow to the aorta.
In the type called the "Taussig Bing" anomaly (top right diagram 2) blood from the LV passes through the VSD to the
Pulmonary Artery, whilst blood from the RV tends to be directed
mainly to the Aorta. This is similar in many ways to Transposition
with a VSD and It may be treated with an 'Arterial Switch'
operation along with a patch within the right ventricle to direct
flow to the arterial valve adjacent to the VSD.
The illustration labelled 'Doubly Committed VSD' (3) shows a rare
variant which may be suitable for repair in a similar way to the
first type. The fourth diagram shows a 'Non Committed
VSD' (4) in which the VSD is distant from both arteries and blood
'mixes' in the right ventricle. This is sometimes suitable for
repair but in other cases a Fontan procedure may be