Author + information
- Received August 11, 2013
- Accepted August 20, 2013
- Published online February 18, 2014.
- Teerapat Yingchoncharoen, MD,
- Luke J. Burchill, MBBS, PhD,
- Janine Arruda, MD,
- Rodolfo Denadai Benatti, MD,
- Karen James, MD,
- W.H. Wilson Tang, MD,
- Robert D. Stewart, MD, MPH,
- Gösta B. Pettersson, MD, PhD and
- Karunakaravel Karuppasamy, MBBS, MSc
A 36-year-old woman presented with palpitations. Examination revealed a precordial thrill and grade 4/6 systolic ejection murmur. Echocardiography showed severe subinfundibular right ventricular outflow tract obstruction with a peak instantaneous gradient of 142 mm Hg (A, Online Video 1) and severe right ventricular hypertrophy. Right heart catheterization demonstrated a high-pressure proximal right ventricle (pRV) and low-pressure distal right ventricle (dRV) (D). These studies suggest that the right ventricle was divided into 2 chambers consistent with double-chambered right ventricle. Cardiac magnetic resonance imaging confirmed this finding (B, Online Video 2) and also showed a nonstenotic bicuspid pulmonic valve (C, arrows, Online Video 3). The patient underwent successful resection of an anomalous muscle bundle in the right ventricular outflow tract. There was no evidence of a ventricular septal defect on magnetic resonance imaging or intraoperative visualization. To our knowledge, this is the first reported case of concomitant double-chambered right ventricle and bicuspid pulmonic valve without ventricular septal defect. PA = pulmonary artery; PV = pulmonic valve; RA = right atrium; TV = tricuspid valve.
- Received August 11, 2013.
- Accepted August 20, 2013.
- American College of Cardiology Foundation