[Classification of aortic and pulmonary artery origin from right ventricle]. / Klassifikatsia otkhozhdenia aorty i legochnoi arterii ot pravogo zheludochka.

ABSTRACT

An original systematics of origin of the aorta and pulmonary artery from the right ventricle (OAPA RV) is suggested on the basis of examination of 63 heart specimens with the anomaly. Two main variants of OAPA RV are distinguished (1) with and (2) without a formed infundibular septum (IS). Types A and DA belong to the first variant, types B, C, D, and DC to the second variant. Type A is characterized by drainage of the left ventricular (LV) outflow tract (OT) into the subaortic conus. Type DA differs from type A by the existence of an auxiliary opening between the ventricles due to a deficiency of tissue of the posterior (sinus part) of the septum. Type B is characterized by the absence (or marked hypoplasia) of the septum of the conus (SC). The LV OT in this case drains under both (aortic and pulmonary) coni. In type C the LV OT opens into the subpulmonary conus. In distinction from type C, type DC has an auxiliary defect in the sinus part of the interventricular septum (IVS). Type D is characterized by complete obturation of the exit and the absence of a defect in the sinus part of the IVS (type D1 OAPA RV with an intact IVS) or with a sinus defect in the IVS-DIVS (type D2 OAPA RV with noncommitted DIVS). According to the presence or absence of stenosis of the pulmonary artery (PA) or aorta, 4 subtypes are distinguished (1) without stenosis; (2) with stenosis of PA; (3) with aortic stenosis; (4) with combined aortic and pulmonary stenosis.