Systemic right ventricle – Cardiology MCQ – Answer

Systemic right ventricle – Cardiology MCQ – Answer

Systemic right ventricle can be seen in all of the following except: Correct answer: 2. Following arterial switch operation for complete transposition of great arteries

In arterial switch operation (Jatene procedure), normal anatomical relationship is restored by switching the aorta and pulmonary artery so that aorta arises from the left ventricle and pulmonary artery arises from the right ventricle. Hence it is a systemic left ventricle and pulmonary right ventricle.

Systemic right ventricle is seen after atrial switch repair for complete transposition of great arteries (Dextro Transposition of great arteries: D-TGA). Atrial switch procedures are Mustard operation and Senning operation. In these procedures the venous return is re-routed at the atrial level so that systemic venous return reaches the pulmonary circulation and pulmonary venous return reaches the systemic circulation. But pulmonary artery remains attached to the left ventricle and aorta to the right ventricle (systemic right ventricle).

Other conditions in which a systemic right ventricle is seen are in congenitally corrected transposition of great arteries (c-TGA or L-TGA), double inlet right ventricle with previous Fontan palliation and hypoplastic left heart syndrome palliated with Norwood-Fontan protocol.

Reference

1. Margarita Brida, Gerhard-Paul Diller, Michael A. Gatzoulis. Systemic Right Ventricle in Adults With Congenital Heart Disease. Anatomic and Phenotypic Spectrum and Current Approach to Management. Circulation. 2018;137:508-518.

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