Single ventricle: a new angiographic classification

The authors recommend that the 'single ventricle' be differentiated into two types. There are single ventricles of the left ventricular type, and others of the primitive type; in other words, the chamber is typically left ventricular or cannot be differentiated into left or right. In the latter case there is a primitive chamber. In addition there may be variations of the large vessels. Of 40 patients with a single ventricle of the left ventricular type, 10 showed normal topography of the major vessels, 13 had a d transposition and 17 an l transposition. In the d transposition, the outflow track of the ventricle was anterior and to the right and the aorta arises in front of the pulmonary artery; in the l transposition the subaortic portion is anterior and to the left, the aorta is ventral and to the left of the pulmonary artery. In the discussion it is pointed out that the 'single ventricle' must be included in the differential diagnosis of cyanotic, congenital heart disease. Angiographic confirmation of the 'single ventricle' depends on the demonstration of an absent ventricular septum and of two separate atrioventricular valves.