Double outlet right vcentrical

(DORV)

Mariem abd elfatah

Out lines: Definition .causes.Types.Signs and symptomsDiagnosis .Treatment .Possible complication .

Definition: Is a heart disease that is present

from birth ( congenital) the aorta connect

to the right ventricle instead of the left ventricle .

Both pulmonary artery and aorta come from the same pumping chamber no arteries connected to left ventricle

Pathophsyiolog: In normal heart structure, the aorta

connected to left ventricle ,the chamber that pumps the blood to the whole body .

The pulmonary normally connect to the right ventricle .

In DORV , both arteries flow out of right ventricle this is a problem because the right ventricle poor oxigenated blood , this blood then circulated into the body.

A nother defect called (vsd) is always occurred with DORV .

Other condition may occur ,pulmonary valve stenosis.

Transposition of the great arteries.

Blood rich in oxygen flow from the lung to the left side of the heart then flow from the Left side throw the (vsd)to the right ventricle.

This help the DORV infant because it allows the oxygnated blood mixed with poor oxgynated blood even this mixing not enough to meet body requirement of oxygen and make the heart work harder to meet body needs.

There are several types of DORV the difference between this types is the location of VSD compared with the location of the pulmonary artery and aorta .

The symptoms and severity of the problem will depend on type of DORV.

The presence of pulmonary stenosis will affect the condition.

People with DORV has another abnormalities such as :

Coarctation of the aorta . Mitral valve problem . Pulmonary atresia . Pulmonary stenosis. Right aortic arch. Transposition of the great arteries.

Types of DORV: There are 4types of DORV V. The type of

DORV that occurs depends on where the VSD is located in relation to the great arteries.

DORV with a subaortic VSD. This means that the VSD is located just

below the aorta. With this type of DORV, blood flows from the left ventricle, through the VSD, and into the aorta. Blood from the right ventricle flows mainly into the pulmonary artery.

DORV with a subpulmonary VSD.

This means that the VSD is located below the pulmonary artery. This type of DORV is also called Taussig-Bing anomaly. With this type of DORV, oxygen-rich blood flows from the left ventricle, through the VSD, and into the pulmonary artery. Oxygen-poor blood from the right ventricle flows mainly into the aorta.

DORV with a doubly committed VSD.

This means that there are 2 VSDs–one below the aorta and one below the pulmonary artery.

DORV with a non-committed (or remote) VSD.

This means that the VSD is not located near the aorta or the pulmonary artery.

Signs and symptoms:

Shortness of breath Heart murmur.Sweating.Extreme tiredness. Difficult or fast breath.Cynosis .No interest in feeding. Loss weight or no weight gain.

Swellen in legs or abdomen. Culbbing ( thickness of nail bed) on

toes and fingers. Pale coloring . Trouble breathing . Sings may include :

Heart enlarged . Rapid breathing Rapid heart beat.

Diagnosis:Chest x_ray .MRI .CTCardiac catheterization to

measure pressure and inject dye for special picture.

Echo cardiogram .

Treatment : Treatments surgical repairthe hole

in the heartheartand direct blood flow to left ventrical .

The surgery depends on some factors:▪ The type of DORF .▪ The severity of the defect.▪ The presence of another heart problem.▪ The pt over all condition.

Possible complications:Congestive heart failure (CHF) .High blood pressure in the

lungs .Irreversible damage to the lung

due to untreated high blood pressure.