Types of DORV based on great artery relation and VSD location
· Side by side relationship of great arteries
o Subaortic VSD
§ Right lateral aorta with subaortic VSD accounts for nearly half of all DORV cases.
§ Both semilunar valves are in the same horizontal plane.
§ VSD is posteroinferior.
o Subpulmonary VSD (TBA)
§ Accounts for 8% of DORV.
§ PS does not occur- so pulmonary trunk is markedly dilated.
§ VSD is anterosuperior.
§ VSD is supracristal.
§ The conus septum may narrow the aortic outflow tract of the RV- subaortic stenosis. This may lead to coarctation of aorta and interrupted aortic arch.
§ There is no conus between the VSD and the pulmonary valve.
o Doubly committed VSD
§ Superior large oblique supracristal VSD related to both semilunar valves.
§ By angiography, this cannot be differentiated from TBA.
o Remote VSD
§ Most common is complete AV septal defect- gooseneck deformity may not be seen.
§ Posteroinferior VSD involving inlet.
§ Muscular VSD.
· Right anterior aorta
o Subaortic VSD- 16% of DORV cases.
o Subpulmonary VSD- 10% of DORV cases. The VSD is subcristal.
o Remote VSD
· Left anterior aorta
o Subaortic VSD- < 5% of DORV cases. Anterosuperior VSD. PS is common.
o Subpulmonary VSD- 4% of DORV cases. Perimembranous VSD.
· Normally related great arteries
o Subaortic posteroinferior VSD is present.
  • Types of DORV based on great artery relation and VSD location

    · Side by side relationship of great arteries

    o Subaortic VSD

    § Right lateral aorta with subaortic VSD accounts for nearly half of all DORV cases.

    § Both semilunar valves are in the same horizontal plane.

    § VSD is posteroinferior.

    o Subpulmonary VSD (TBA)

    § Accounts for 8% of DORV.

    § PS does not occur- so pulmonary trunk is markedly dilated.

    § VSD is anterosuperior.

    § VSD is supracristal.

    § The conus septum may narrow the aortic outflow tract of the RV- subaortic stenosis. This may lead to coarctation of aorta and interrupted aortic arch.

    § There is no conus between the VSD and the pulmonary valve.

    o Doubly committed VSD

    § Superior large oblique supracristal VSD related to both semilunar valves.

    § By angiography, this cannot be differentiated from TBA.

    o Remote VSD

    § Most common is complete AV septal defect- gooseneck deformity may not be seen.

    § Posteroinferior VSD involving inlet.

    § Muscular VSD.

    · Right anterior aorta

    o Subaortic VSD- 16% of DORV cases.

    o Subpulmonary VSD- 10% of DORV cases. The VSD is subcristal.

    o Remote VSD

    · Left anterior aorta

    o Subaortic VSD- < 5% of DORV cases. Anterosuperior VSD. PS is common.

    o Subpulmonary VSD- 4% of DORV cases. Perimembranous VSD.

    · Normally related great arteries

    o Subaortic posteroinferior VSD is present.