Cardiovascular ImagingSingle ventricle
(also called univentricular atrioventricular connection and univentriclar heart), a group of complex cyanotic
congenital anomalies in which both atrioventricular valves open into a single
ventricle. Single
ventricle is frequently associated with abnormal connections or positions of the great arteries such as transposition and malposition. The dominant
ventricle receives both atrioventricular valves and the other
ventricle is small. The dominant
ventricle has a left ventricular morphology in 80% of cases but less frequently has right ventricular morphology or primitive morphology. A bulboventricular foramen separates the dominant left
ventricle from the small right ventricular chamber. The small right ventricular outlet chamber may be positioned anterior (noninverted) or to the left (inverted) of the dominant left
ventricle. These arrangements are frequently accompanied by D-transposition and L-transposition, respectively. Chest
X-ray shows either
pulmonary plethora or oligaemia depending upon associated lesions causing
obstruction of
pulmonary blood flow. With inverted outlet chamber the appearance may be similar to L-transposition with prominent convexity on the upper left
cardiac border.
Echocardiography and
MRI demonstrate the atrioventricular connections, bulboventricular foramen, size and position of the outlet chamber and relationship of the great arteries (
Fig.1).
Cardiac catheterization and
cardiac angiography can define the size of the bulboventricular foramen but is less effective for demonstrating the atrioventricular valves.
CBH
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ECG gated spin echo images demonstrate the dominant left ventricle connected via a bulboventricular foramen (arrow) to the right ventricle outlet chamber (R) from which the levo transposed aorta (A) originates (a). The images also demonstrate pulmonary valvular atresia with hypoplasia of the central pulmonary arteries (arrowheads) (b).
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Single ventricle, Fig.1 (a) | | Single ventricle, Fig.1 (b) | |