DORV; Taussig-Bing anomaly; DORV with doubly-committed VSD; DORV with noncommitted VSD; DORV with subaortic VSD

Symptoms of DORV may include:

• Baby tires easily, especially when feeding
• Bluish skin color (the lips may also be blue)
• Clubbing (thickening of the nail beds) on toes and fingers (late sign)
• Failure to gain weight and grow
• Pale coloring
• Sweating
• Swollen legs or abdomen
• Trouble breathing

Signs of DORV may include:

• Enlarged heart
• Heart murmur
• Rapid breathing
• Rapid heartbeat

Tests to diagnose DORV include:

• Chest x-rays
• Passing a thin, flexible tube into the heart to measure blood pressure and inject dye for special pictures of the heart and arteries (cardiac catheterization)
• Ultrasound exam of the heart (echocardiogram)
• Using magnets to create images of the heart (MRI)

Treatment requires surgery to close the hole in the heart and properly direct blood from the left ventricle into the aorta. Surgery may also be needed to move the pulmonary artery or aorta.

Several factors determine the type and number of operations the baby needs. They include:

• The type of DORV
• The severity of the defect
• The presence of other problems in the heart
• The child's overall condition

See also:

• Congenital heart defect corrective surgery
• Pediatric heart surgery

How well the baby does depends on several factors:

• The size of the VSD
• Its location
• The size of the pumping chambers
• The location of the aorta and pulmonary artery
• The presence of other complications (such as coarctation of the aorta and mitral valve problems)
• The baby's overall health at the time of diagnosis
• Whether lung damage has occurred from too much blood flowing to the lungs for a long period of time

Complications from DORV may include:

• Congestive heart failure (CHF)
• High blood pressure in the lungs
• Irreversible damage to the lungs due to untreated high blood pressure in the lungs

All children with this congenital heart disease should take antibiotics before dental treatment. This prevents infections around the heart. Antibiotics may also be needed after surgery.

Baldwin HS, Dees Ellen. Embryology and physiology of the cardiovascular system. In: Gleason CA, Devaskar S, eds. Avery's Diseases of the Newborn. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 50.