[Table/Fig-11]:

DORV

DORV [13]	Characterized by origin of both great arteries predominantly from RV, bilateral muscular infundibula and absence of AV-semilunar valve continuity.
4 Subtypes (based on location of VSD in relation to great arteries)	DORV with subaortic VSD blood from LV flows via VSD to aorta and blood from RV flows mainly to PA= physiology similar to VSD DORV with subpulmonic VSD (Taussig-Bing syndrome) blood from LV flows via VSD to PA and blood from RV flows mainly to aorta= physiology similar to TGA DORV with doubly committed VSD absent infundibular septum DORV with non-committed VSD, VSD remote from aortic and pulmonary valves
Incidence	1-3% of all CHD. M:F ratio=2:1
Association	Coarctation of aorta Interrupted aortic arch Pulmonary obstruction
Syndromes	Trisomy 13, 18 Deletion 22q11
Imaging features Plain	Without pulmonary obstruction	Moderate cardiomegaly (RV type), convex MPA, pulmonary plethora, thymic atrophy and hyperinflated lungs
	With pulmonary obstruction	Mild cardiomegaly (RV type), concave MPA segment, pulmonary oligemia and left arch
Imaging features specific	Echo side by side orientation of great vessels with aorta anterior and to the right; overriding of aorta; absent fibrous continuity of semilunar and AV valves MRI very helpful for localization and relation of VSD to great arteries CT.
Management [13]	Palliative: Pulmonary artery banding for uncontrollable CHF in infancy Balloon atrial septostomy for Taussig-Bing anomaly Systemic-to-PA shunting- in pts with associated PS Definitive repair: Total correction= VSD closure with placement of internal and external conduits to establish physiological blood flow between LV/aorta and RV/PA.