Diagnosis of the anatomic types of single or common ventricle

Abstract

The present report seeks to determine whether or not one can accurately diagnose the various anatomic types of single ventricle by clinical and laboratory methods. The history, physical examination, chest roentgenograms and electrocardiogram usually were diagnostically nonspecific. Despite its lack of specificity, the electrocardiogram in single left ventricle with an infundibular outlet chamber usually could be understood in terms of the type of bulboventricular loop which was present. Cardiac catheterization often provided the first clue to the presence of a single ventricle: a large left to right shunt at the ventricular level, despite systemic pressure in the “right” ventricle; and an extraordinarily wide range of oxygen content from different sites in the ventricle, and even from the same site. Selective ventricular angiocardiography is the diagnostic method of choice. Two groups can be distinguished: (1) single ventricle with an outlet chamber, and (2) single ventricle without an outlet chamber. Those with an outlet chamber have absence of the right ventricular sinus (inflow tract). This results in a single left ventricle with an infundibular outlet chamber, the relatively frequent type of single ventricle (79% of this series).