Univentricular heart simplified, (double inlet ventricle, single ventricle)

Normal ventricle contains Inlet, Outlet, and Trabacular. On left side both inlet and outlet part is fused. IVS divides not only divides right and left ventricles but also each ventricle in to inlet outlet and Trabacular parts.

What is ventricle?
·        To call a chamber as ventricle, at least 50% of inlet  must be committed chamber
·        In normal hearts each Trabacular portion receives its own inlets
·        Outlet is not mandatory for ventricle classification
·        In single ventricles all inlets are committed to single Trabacular portion so double inlets ventricle is also preferred term.
Classification of univentricle
1.     Left
2.     Right
3.     Indeterminate
Left Univentricular type
This constitutes 80% to 90% of Univentricular type. Chamber that receives blood from both atria has left ventricular morphology.
Ventricular chamber incorporates an outlet chamber (OC) which present anteriorly and gives raise to great vessel. In D-loop Univentricular type outlet chamber is situated right and anterior and L-loop Univentricular heart OC is placed left and anterior.
Holmes heart this is uncommon left type Univentricular heart variety. Here aorta arises from ventricle and pulmonary trunk from OC.
Rarely OC gives raise to both great arteries or common trunk or no great artery at all.
Left Univentricular Heart
Right Univentricular type
Chamber receiving blood from atria is morphological right ventricular type. Trabacular pouch is situated posterioraly. Both great arteries arise from ventricle.
Occasionally pulmonary artery arises from right ventricle and aorta from Trabacular pouch (which is left ventricle remnant)
Right Univentricular Heart
Indeterminate type
No Trabacular pouch or OC is found. Blood receiving from atria is morphological resemble
Out let chamber and rudimentary pouch
Some books use these terms inter changeably. Outlet chamber gives raise at least to one great vessel Rudimentary pouch is blind
Bulbventricular foramen
This is connection between ventricle and OC or Trabacular pouch. VSD term should not used.

Author: Dr Umesh Bilagi

MBBS, MD, DM (cardiology). I am Interventional cardiologist. Blogging is my passion. Associate professor of cardiology KIMS Hubli. Director and consultant at Tatwadarsha Hospital Hubli. Owner of Jeevan Jyoti Hospital Hubli. Mobile +91 9343403620.

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