Keeton B R, Macartney F J, Hunter S, Mortera C, Rees P, Shinebourne E A, Tynan M, Wilkinson J L, Anderson R H
Circulation. 1979 Feb;59(2):403-11. doi: 10.1161/01.cir.59.2.403.
Seventeen cases are described in which both atria connect directly to a chamber with right ventricular characteristics. The atria connected through separate atrioventricular valves in six hearts and a common valve in 11. All hearts had a posterior rudimentary chamber. The septum which separated it from the main chamber was directed to the crux of the heart. Ten hearts were from patients with atrial situs solitus and seven from patients with atrial situs ambigous. Arterial connections were concordant in three cases, had a double outlet from the main ventricular chamber in nine and single outlet of the heart in five. The patent artery always arose from the main chamber, with pulmonary atresia in three and aortic atresia in two. This and other studies indicate that double inlet atrioventricular connection does not predict the morphology of the main chamber. Although usually associated with a main chamber of left ventricular type, it may also be associated with a main chamber having right ventricular characteristics. Both types should be considered as univentricular hearts; the posterior chamber in hearts of right ventricular type are analogous to the anterior chamber in univentricular hearts of left ventricular type and are a rudimentary chamber rather than a hypoplastic ventricle. In the right ventricular form of univentricular heart, the trabecular zone of the rudimentary chamber is of left ventricular type.
本文描述了17例心房均直接连接至具有右心室特征腔室的病例。其中6例心脏的心房通过各自的房室瓣相连,11例通过共同瓣膜相连。所有心脏均有一个后方的残腔。将其与主腔室分隔开的间隔指向心脏十字交叉。10例心脏来自心房正位患者,7例来自心房位置不明确患者。3例病例动脉连接一致,9例主心室腔有双出口,5例心脏为单出口。开放动脉总是起源于主腔室,3例有肺动脉闭锁,2例有主动脉闭锁。本研究及其他研究表明,双入口房室连接并不能预测主腔室的形态。虽然通常与左心室型主腔室相关,但也可能与具有右心室特征的主腔室相关。这两种类型均应视为单心室心脏;右心室型心脏中的后腔类似于左心室型单心室心脏中的前腔,是一个残腔而非发育不全的心室。在右心室型单心室心脏中,残腔的小梁区为左心室型。