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Double Outlet of the Right Ventricle (DORV)

Double Outlet of the Right Ventricle (DORV) belongs to a category of birth defects known as conotruncal heart defects, or outflow tract defects.

What it is

In a normally functioning heart, each of ventricles has one outlet, or artery. On the left side, this should be the aorta and on the right should be the pulmonary artery. For babies with DORV, both the aorta and the pulmonary artery arise from the right ventricle. Most DORV cases are accompanied by a ventricular septal defect (VSD). The baby may also suffer from other defects, such as transposition of the great arteries (TGA) or pulmonary stenosis (PS).

The existence of a VSD in conjunction with DORV allows the oxygen-rich blood and oxygen-poor blood to flow between the VSD opening from the left to the right side of the heart. Normally this blood would be transferred separately by the aorta and pulmonary artery. Although the VSD makes it possible for the infant’s body to receive high-oxygen (red) blood, this blood is still diluted by low-oxygen (blue) blood, making the baby’s heart work harder to pump the proper amount of oxygen to the body. There are a number of tests that your doctor can perform to diagnose DORV.

Symptoms

  • Baby tires easily, especially when feeding
  • Bluish skin color (the lips may also be blue)
  • Clubbing (thickening of the nail beds) on toes and fingers (late sign)
  • Failure to gain weight and grow
  • Pale coloring
  • Sweating
  • Swollen legs or abdomen
  • Trouble breathing

Causes

Anti-depressants: Several studies have linked maternal use of anti-depressants to an increased risk of the infant being born with DORV and other congenital heart defects. This means infants whose mothers took certain anti-depressants just before or during pregnancy are more than twice as likely to develop conotruncal defects such as DORV than unexposed babies. For more information, click any of the drug names below. Anti-depressants include:

Treatment

Treatment entails surgery to direct the oxygen-rich blood to the body and the oxygen-poor blood to the lungs. This can be accomplished in many ways, depending on the kind of DORV. Any other congenital heart defects will also need to be fixed at the same time. The type and number of operations the baby will undergo relies on several factors, including:

  • Type of DORV
  • Severity of the defect
  • Presence of other problems in the heart
  • Child’s overall condition

 

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