• a Pulmonalstenose, which can be present narrowing of the lung artery flap, either underneath the Herzklappe from musculature and connective tissue at the flap and/or from a combination of both.
• an atrium septum defect (hole in the pre-chamber septum)
• a persisting Ductus arteriosus, a far existing vorgeburtlichen connection between Aorta and lung artery
• a Aortenisthmusstenose, the narrowing of the Aorta in the aortic arch
• a Transposition of the large Arterien, the permutation of Aorta and lung artery

The development of this heart error can be very different, after, which false education combination is present. In some cases the disease picture in the demarcation depends over-riding"” Aorta to the Fallot' Tetralogie only on that more or less strongly "“. Over the VSD venous and arterial blood is mixed. A cyanosis develops.

If the VSD lies below the Aorta and if no Pulmonalstenose exists, increases blood flows into the lung cycle, which can lead with longer existing defect to a Pulmonalen hypertonia. Anatomy can be very similar then possibly some "“simple"” VSD. The difference is only that that with the DORV the Aorta is shifted opposite the heart septum more or less forward, above or right. The demarcation is gradual and flowing. If the Aorta rides more than 50% of its extent over the VSD, one speaks of a DORV.Liegt of the VSD underneath the lung artery and exists a Pulmonalstenose, evades more bloods into the Aorta. Since the lung is protected against a flooding thereby, it does not come to the symptoms of a heart insufficiency.

Diagnostics

• Echokardiografie as proving not invasive research method
• ELECTROCARDIOGRAM
• Roentgen
• Heart catheter investigation usually as supplementing investigation for the operational planning (particularly during a complex false formation)

Therapy

The surgical correction with the help of the heart lung machine depends on the weight of the heart error. The goal is the production of a normal or as far as possible the standard approximate anatomy. The following is possible:

• in-early correction for "“simple variants"”
• Catch of the VSD and correction of the Pulmonalstenose by extension or implantation of a Homograft (human donor flap)
• the VSD lies below the Pulmonalklappe or below both large Arterien and/or far from the containers far away in the musculature of the heart septum is used an Rastelli operation.
• by the catch of the VSD if the right ventricle and the left ventricle of the lung artery are assigned to the body artery, and exist a Transposition of the large Arterien, a "“arterial SWITCH operation"” is accomplished.
• with the operation after Damus Kaye Stensel the Transposition of the large Arterien is corrected by the fact that the lung artery is attached laterally to the body artery
• the Fontan operation is rare with very complicated anatomical conditions

Sometimes the plant one precedes the correction operation aorto to pulmonalen Shunts (with strong cyanosis) or the plant of a Pulmonalen Bandings (during flooding of the lung). These two Voroperation are accomplished without employment of the heart lung machine.

Treatment results and prognosis

The correction can be relatively simple with very good operation results. With complex forms still problems can occur also later. A low-grade of far existing narrowing or leakage of the Pulmonalstenose can win at meaning and make a later operation necessary. A small far existing VSD has usually no meaning. A restricting in the discharge course of the left Herzkammer (Aortenklappe) makes usually a rapid renewed interference necessary. Since this operation often lies in the proximity of the excitation line system, lasting heartbeat disturbances can occur. General prognoses are not possible in view of the variety of this heart error.

Lifelong control investigations are necessary. Likewise the adherence to the Endokarditisprophylaxe.

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Articles in category "Double outlet right Ventricle"

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