Cardiovascular Imaging

Ventriculoarterial connections

the relationships between the ventricles and the great arteries. The normal connections are aorta originating from the left ventricle and the pulmonary artery originating from the right ventricle. These are concordant ventriculoarterial connections. Discordant connections are aorta originating from the right ventricle and pulmonary artery originating from the left ventricle which constitutes complete transposition of the great arteries. Other abnormalities of ventriculoarterial connections are double outlet right ventricle and double outlet left ventricle. Echocardiography, MRI and cardiac angiography can identify the type of ventriculoarterial connections (Fig.1). For this purpose, ventricular identity depends upon demonstration of a conus for the right ventricle and semilunaratrioventricular valve continuity for the left ventricle.

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Fig.1

ECG gated spin-echo images at level of great arteries (a) and mid ventricles (b). Aorta is anterior and leftward from the pulmonary artery indicating L-transposition. Left ventricle (L) is situated to the right of the right ventricle (R) indicating L-ventricular loop. Aorta originates from the right ventricle which is discordant ventriculoarterial connections. This is isolated dextrocardia. Note the moderator band (arrow) of the right ventricle.
Ventriculoarterial connections, Fig.1 (a)
Ventriculoarterial connections, Fig.1 (b)