The Roentgenologic Findings in Common Ventricle with Transposition of the Great Vessels

Abstract

Sixteen cases of common cardiac ventricle with transposition were studied to determine whether a specific roentgenologic pattern could be detected. In common ventricle with transposed great vessels, there is one ventricular chamber into which both atrioventicular valves empty. The same chamber gives rise to the pulmonary trunk and, through its infundibular or rudimentary chamber, to the transposed aorta. In each case studied, the infundibular chamber was located anteriorly at the base of the heart in one of two positions. In 10 cases (Group I), the infundibulum was located at the left aspect of the base of the heart and was designated as inverted. In the remaining 6 cases (Group II), the infundibulum was at the right aspect of the base of the heart and was considered noninverted. The distribution of cases with pulmonary stenosis was slightly greater in Group II (2 of 6 cases) than in Group I (1 of 10 cases). When common ventricle existed with inversion of the infundibulum, the general arrangement of the great vessels at the basal aspects of the heart was essentially like that in corrected transposition. With common ventricle and noninversion, the plain films were similar to those of complete transposition. Thus, when selective angiocardiography was performed, the diagnosis of both types of common ventricle depended on: (a) visualization of the large, smooth-walled common ventricular chamber; (b) demonstration of the infundibular chamber communicating directly with the common ventricle from below and the transposed aorta above; (c) equal or near-equal opacification of both great vessels; (d) distinct separation of the atrio-ventricular valves and the infundibulum; and (e) the pulmonary trunk arising directly from the common ventricle without the presence of the ventricular septum. It is concluded that the plain films in common ventricle, while suggestive, are not specific and may be similar to other conditions having transposition and two functioning ventricles. Selective angiocardiography, however, results in specific findings for common ventricle.