[Angiocardiographic diagnosis in right ventricular dysplasias]

Abstract

Right ventricular dysplasia (RVD) is characterised by fatty and fibrous infiltration of the right ventricular wall and usually presents clinically with ventricular arrhythmias. The aim of this study was to determine the morphological changes of RVD and establish diagnostic criteria applicable in cases with atypical clinical signs or electrocardiographic changes. The angiocardiographic data of 10 cases of RVD was reviewed. 8 cases were complicated by right ventricular arrhythmias. The other 2 cases were not arrhythmogenic but had highly suggestive ECG changes; there were no other causes of right ventricular disease. Selective right ventriculography was performed with the catheter positioned in the inflow tract distal to the moderator band. In the 8 cases without tricuspid regurgitation there was one constant finding: the presence of parietal fissuration with massive impregnation of the ventricle distal to the moderator band. Two signs were commonly observed; the stagnation of contrast in the inferior regions of the right ventricle during left ventricular opacification (6/8 cases); irregular opacification of the pulmonary infundibulum (5/8 cases); an infundibulor aneurysm was observed in 1 case. Biometrical data was normal in all 8 cases compared with a control group of 10 normal subjects: the right ventricular disease was segmental and not diffuse. It was associated with a moderate alteration of left ventricular function and with segmental abnormalities of wall motion in 2 cases. None of these signs were observed in the right ventriculographies of 7 cases of typical dilated cardiom-opathies. These 4 signs were not found in 2 cases with tricuspid regurgitation where changes were essentially limited to a dilatation of the right ventricular inflow tract.(ABSTRACT TRUNCATED AT 250 WORDS)