{"id":21565,"date":"2016-09-08T05:00:17","date_gmt":"2016-09-07T23:30:17","guid":{"rendered":"https:\/\/cardiophile.org\/?p=21565"},"modified":"2016-09-08T05:00:17","modified_gmt":"2016-09-07T23:30:17","slug":"cxr-showing-dilated-rvot","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/cxr-showing-dilated-rvot\/","title":{"rendered":"CXR showing dilated RVOT"},"content":{"rendered":"<h2><span style=\"color: #008000;\">CXR showing dilated RVOT<\/span><\/h2>\n<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/xo9d0Wps9Q8\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<figure id=\"attachment_21567\" aria-describedby=\"caption-attachment-21567\" style=\"width: 471px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-21567 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/09\/RVOT.jpg\" alt=\"RVOT\" width=\"471\" height=\"444\" \/><figcaption id=\"caption-attachment-21567\" class=\"wp-caption-text\"><strong><em><span style=\"color: #0000ff;\">CXR showing dilated RVOT<\/span><\/em><\/strong><\/figcaption><\/figure>\n<p>Chest X-ray PA view showing a bulge along the left border, below the aortic\u00a0knuckle\u00a0and pulmonary bay. Sternal\u00a0wires are seen near the\u00a0mid line, which would suggest that the person has possibly undergone a cardiac\u00a0surgery by sternotomy.<\/p>\n<p>Bulge below the pulmonary bay can be due to several reasons:<\/p>\n<ol>\n<li>Prominent left atrial appendage as in severe mitral stenosis<\/li>\n<li>Dilated right ventricular outflow tract as in Ebstein&#8217;s anomaly or endomyocardial fibrosis<\/li>\n<li>Submitral left ventricular aneurysm<\/li>\n<li>Bulge due to partial absence of left pericardium<\/li>\n<li><a href=\"https:\/\/johnsonfrancis.org\/professional\/mesocardia-with-l-tga-2\/\">Levoposed aorta in L-Transposition of great arteries<\/a>.<\/li>\n<li>Dilated RVOT (right ventricular outflow tract) can occur in case of severe pulmonary regurgitation after repair of Tetralogy of Fallot with a transannular patch.<\/li>\n<\/ol>\n<p>The most likely possibility in this person with evidence of previous sternotomy is the last option. Davlouros PA et al, in a study of 85 patients after repair of tetralogy of Fallot, found right ventricular outflow tract aneurysm\/akinesia in 56% of them [1]. This was documented by magnetic resonance imaging. RVOT aneurysm was noted in 16 patients while akinesia was found in 32 patients.<\/p>\n<p>This non contractile region of the right ventricular outflow tract contributes to a decreased right ventricular ejection fraction. This finding was noted in those who did not have a patch in the RVOT also. Non contractile region in those who did not have a patch repair could be due to infundibular resection and interruption of the conal branch of right coronary artery [1].<\/p>\n<p>Right ventricular outflow tract aneurysms late after repair of tetralogy of Fallot in adult patients has been associated with sustained ventricular tachycardia [2].<\/p>\n<p><strong><span style=\"color: #0000ff;\">References<\/span><\/strong><\/p>\n<ol>\n<li>Davlouros PA, Kilner PJ, Hornung TS, Li W, Francis JM, Moon JC, Smith GC, Tat T, Pennell DJ, Gatzoulis MA. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12475468\/\">Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging: detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction<\/a>. J Am Coll Cardiol. 2002 Dec 4;40(11):2044-52.<\/li>\n<li>Harrison DA, Harris L, Siu SC, MacLoghlin CJ, Connelly MS, Webb GD, Downar E, McLaughlin PR, Williams WG. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9350941\/\">Sustained ventricular tachycardia in adult patients late after repair of tetralogy of Fallot<\/a>. J Am Coll Cardiol. 1997 Nov 1;30(5):1368-73.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>CXR showing dilated RVOT Chest X-ray PA view showing a bulge along the left border, below the aortic\u00a0knuckle\u00a0and pulmonary bay. Sternal\u00a0wires are seen near the\u00a0mid line, which would suggest that the person has possibly undergone a cardiac\u00a0surgery by sternotomy. Bulge below the pulmonary bay can be due to several reasons: Prominent left atrial appendage as [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":42648,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[4,9],"tags":[571,3455],"class_list":["post-21565","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiology-x-ray","category-general","tag-bulge-below-the-pulmonary-bay","tag-rvot-aneurysm"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Chest X-ray showing dilated right ventricular outflow tract<\/title>\n<meta name=\"description\" content=\"Dilated RVOT (right ventricular outflow tract) can occur in case of severe pulmonary regurgitation after repair of Tetralogy of Fallot.\" \/>\n<meta name=\"robots\" content=\"index, follow, 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