Origin of Both Great Vessels from the Right Ventricle

THE FIRST PAPER' of this series dealt with the origin of both great vessels from the right ventricle in the absence of pulmonary stenosis. It was indicated that the clinical picture in that condition might be confused with that of a large ventricular septal defect. Electrocardiographically, such an anomaly might be confused with either a persistent common atrioventricular canal2 or the "AV commune" type of ventricular septal defect.3 The condition forming the basis for the present communication anatomically has in common with the foregoing anomaly the origin of both great vessels from the right ventricle, but pulmonary stenosis is also present. The hemodynamic, clinical, and electrocardiographic data resemble those in the tetralogy of Fallot. This part of the study includes five cases in which both great vessels originated from the right ventricle associated with ventricular septal defect and pulmonic stenosis, and a sixth case, in which both great vessels took origin from the right ventricle and in which a common atrioventricular canal and pulmonic stenosis were associated. The purpose of this paper is to summarize the clinical, hemodynamic, and anatomic findings in these cases. The differentiation of this anomaly from the tetralogy of Fallot with cyanosis is important because of the more complicated surgical approach in the former. This anomaly has been described before in articles devoted to pathology, but only in