ORIGIN OF BOTH GREAT VESSELS FROM RIGHT VENTRICLE ASSOCIATED WITH SEVERE OBSTRUCTION TO LEFT VENTRICULAR OUTFLOW

A patient is described in whom both the aorta and pulmonary artery arose from the right ventricle. Obstruction to right ventricular outflow resulted from anomalous muscle bundles, and a small ventricular septal defect was the site of severe obstruction to left ventricular outflow. The preoperative clinical findings, and the results of the hemodynamic and angiographic studies by which the diagnosis was established, are presented. At operation, the ventricular septal defect was enlarged, and left ventricular outflow was directed into the aorta by a prosthesis. Normal intracardiac pressures and the absence of any intracardiac shunt were demonstrated at late postoperative study. When both great arteries originate from the right ventricle, the clinical and hemodynamic findings are determined by the position and size of the ventricular septal defect and by the presence or absence of pulmonary stenosis. The various physiologic abnormalities which result from this malformation are related to the specific anatomic defects. © 1969.