Double outlet right ventricle

Double outlet right ventricle means that both the aorta and the pulmonary artery originate from the right ventricle, or one great artery and the majority of the other great artery originate from the right ventricle, with the ventricular septal defect being the only outlet of the left ventricle. The hemodynamic changes in double outlet right ventricle mainly depend on the location and size of the ventricular septal defect, as well as whether pulmonary stenosis is present and its severity. When the ventricular septal defect is located below the aortic valve without pulmonary stenosis, most of the left ventricular blood flow passes directly through the defect into the aorta, while right ventricular blood mainly enters the pulmonary artery, resulting in increased pulmonary blood flow, and the clinical presentation is similar to simple ventricular septal defect combined with pulmonary hypertension. The ventricular septal defect is usually larger than the aortic orifice; in only 10% of cases is the ventricular septal defect smaller than the aortic opening. Approximately 60% of ventricular septal defects are located below the aortic valve, 30% below the pulmonary valve, and in a small number of cases the ventricular septal defect is located in the middle area between the aortic and pulmonary openings. In very rare cases, the ventricular septal defect is located in the middle-lower portion of the ventricular septum, relatively far from the great artery openings.