ECHOCARDIOGRAPHIC MORPHOLOGICAL CLASSIFICATION OF UNIVENTRICULAR HEART PATIENTS IN SULAIMANI PEDIATRIC TEACHING HOSPITAL / KURDISTAN / IRAQ

Abstract

Background 
 A “single ventricle” or “univentricular heart” was characterized by lacking two well-developed ventricles, which thereby excluded hearts with nonseptable but well-formed ventricles. The proposed definition of univentricular heart encompassed double-inlet atrioventricular connection, absence of atrioventricular connection (mitral or tricuspid atresia), double-outlet right ventricle, common atrioventricular valve with only one well-developed ventricle, and heterotaxy syndrome (single ventricle heterotaxy syndrome).
 Objectives 
 To determine the echocardiographic morphological classification of patients with univentricular heart disease and the subclassification of each type in Sulaimani PediatricTeaching Hospital-Cardiology Unit–Kurdistan-Iraq
 Patients and Methods
 A retrospective study conducted in pediatric teaching hospital in Suaimani city from September 2009 to January 2014. All children with the confirmed diagnosis of single ventricle were included in the study, hypoplastic left heart syndrome have been excluded from the study. The source of information was the medical and echocardiography records from cardiology unit of the pediatric teaching hospital in Sulaimani by the same pediatric cardiologist as an operator.
 Results
 Among 100 cases, 73 cases had left ventricle morphology, 24 cases had right ventricle morphology, and 3 cases of indeterminate type. 50 cases were tricuspid atresia, 22 cases were double inlet left ventricle, 17 cases were double outlet right ventricle, 10 cases were common atrioventricular valve, and one case was double inlet right ventricle. Type (I) tricuspid atersia was the most common subtype of tricuspid atresia (80%). Transposition of great arteries was the most common type of double inlet left ventricle (95%). Tetrallogy of Fallot was the most common subtype of double outlet right ventricle (59%). Ventricular septal defect was the most common associated anomaly, followed by atrial septal defect. 
 Conclusion
 Tricuspid atresia is the most common type of univentricular heart (with exclusion of hypoplastic left heart synsdrome). Tricuspid atersia with normally related great arteries is the most common subtype of tricuspid atersia. Right isomerism is more common in male patients, and right isomerism is more common than left isomerism. Ventricular septal defect & atrial septal defect are the most common associated anomalies. There is a possibility of a genetic role in patients with tricuspid atersia that increases its incidence in other siblings.