Surgical Approaches to Double Outlet Right Ventricle
Summary
Double outlet right ventricle (DORV) encompasses a spectrum of congenital ventriculoarterial connections in which both the aorta and pulmonary artery originate predominantly or entirely from the right ventricle. Surgical repair aims to achieve unobstructed systemic and pulmonary flow by routing left ventricular output to the aorta and alleviating any right ventricular outflow obstruction. Traditional techniques include intraventricular tunnel (baffle) creation through a ventricular septal defect (VSD), as exemplified by the Rastelli procedure, which uses a conduit to connect the right ventricle to the pulmonary artery when native outflow is inadequate. The arterial switch operation, adapted for selected DORV subtypes, repositions the great arteries to their correct ventricles, offering excellent haemodynamic results but requiring careful coronary artery transfer. The Nikaidoh procedure entails translocating the aortic root into alignment with the left ventricle and reconstructing the right ventricular outflow tract, particularly useful in subaortic VSD with ventricular outflow mismatch. Advances in three-dimensional imaging and computational modelling now inform patient-specific planning, optimise baffle geometry and minimise re-intervention rates. Multimodal strategies address associated anomalies such as aortic arch hypoplasia and coronary variations, underscoring the need for tailored surgical approaches in centres equipped for complex intracardiac reconstruction.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Surgical Approaches to Double Outlet Right Ventricle publication trend
The graph below shows the total number of articles in surgical approaches to double outlet right ventricle across all publications each year (not limited to Nature Index journals).
Technical terms
Double outlet right ventricle (DORV): A congenital malformation in which both great arteries arise predominantly from the right ventricle.
Ventricular septal defect (VSD): An opening in the interventricular septum permitting abnormal blood flow between ventricles.
Intraventricular tunnel (baffle): A surgically constructed channel directing left ventricular blood through a VSD to the aorta.
Rastelli procedure: A repair using an intraventricular baffle and a right ventricle–to–pulmonary artery conduit for DORV with pulmonary stenosis.
Arterial switch operation: A technique that repositions the aorta and pulmonary artery to their anatomically correct ventricles, including coronary transfer.
Nikaidoh procedure: A surgical approach involving aortic root translocation and reconstruction of the right ventricular outflow tract in select DORV cases.
References
- Double outlet right ventricle. Frontiers in Pediatrics (2023).
- Numerical Simulation of the Influence of Geometric Configurations on Pressure Difference in the Intraventricular Tunnel. Frontiers in Physiology (2020).
- Aortic Arch Phenotypes in Double Outlet Right Ventricle (DORV)—Implications for Surgery and Multi-Modal Imaging. Journal of Cardiovascular Development and Disease (2022).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.