Education  |   January 2019
Double-chambered Right Ventricle
Author Notes
  • From the Departments of Anesthesiology (J.S.M., A.J.B., A.M.K.) and Pediatrics (J.E.V.), University of Virginia, Charlottesville, Virginia.
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Address correspondence to Dr. Kleiman: ak8zg@hscmail.mcc.virginia.edu
Article Information
Education / Images in Anesthesiology / Cardiovascular Anesthesia / Pediatric Anesthesia
Education   |   January 2019
Double-chambered Right Ventricle
Anesthesiology 1 2019, Vol.130, 150-151. doi:10.1097/ALN.0000000000002438
Anesthesiology 1 2019, Vol.130, 150-151. doi:10.1097/ALN.0000000000002438
Double-chambered right ventricle is diagnosed with transesophageal or transthoracic echocardiography by the presence of a high-pressure proximal region under the tricuspid valve and a low-pressure distal region near the pulmonary valve with high-velocity, turbulent flow created by anomalous muscle bands in the right ventricular outflow tract (image panels A and B; PA, pulmonary artery; RV, right ventricle; RVOT, right ventricular outflow tract). The midesophageal right ventricular inflow–outflow view shows classic right ventricular outflow tract obstruction from anomalous muscle narrowing the outflow to a diameter of 0.45 cm (normal ~2.2 cm; panel A). If pressure gradients are difficult to obtain, the diagnosis of double-chambered right ventricle can be made by the presence of abnormal acceleration of flow within the right ventricle using color flow Doppler.1  Color flow Doppler placed across the significantly narrowed right ventricular outflow tract in this patient demonstrated a mosaic pattern from high-velocity, turbulent flow (panel B; Supplemental Digital Content, http://links.lww.com/ALN/B785) diagnostic of double-chambered right ventricle. Color flow Doppler may also be used to determine the exact location of flow obstruction and high- and low-pressure chambers if unclear with two-dimensional imaging.