TY  - EJOU
AU  - Aryal, Shilpa 
AU  - Mood, Marhisham Che 
AU  - Sivalingam, Sivakumar 
AU  - Karyostyko, Boekhren 
AU  - Ramdzan, Yusoff 
AU  - Latiff, Haifa Abdul 
AU  - Leong, Ming Chern 

TI  - Role of Imaging in Surgical Decision Making for Patients with Double Outlet Right Ventricle
T2  - Structural and Congenital Heart Disease

PY  - 2026
VL  - 21
IS  - 3
SN  - 3071-1738

AB  - <b>Background:</b> Double-outlet right ventricle (DORV) encompasses a spectrum of disorders characterized by both great vessels arising from the right ventricle. This study compared the diagnostic accuracy of multislice computed tomography (MSCT) and transthoracic echocardiography (TTE) in predicting the optimal surgical strategy by evaluating the concordance between preoperative imaging-based decisions and intraoperative findings. <b>Methods:</b> This single-center, retrospective study included 112 patients with DORV (56 MSCT + TTE and 56 TTE only) who underwent surgical correction between January 2010 and December 2024. Agreement between preoperative and intraoperative surgical decisions was assessed by weighted kappa (κ). Diagnostic accuracy was calculated using sensitivity, specificity, positive predictive value, and negative predictive value. <b>Results:</b> Median weight was 8.40 kg in the combined MSCT + TTE group and 9.56 kg in the TTE-only group. TTE demonstrated high concordance with intraoperative surgical findings (κ = 0.93), whereas the combined MSCT + TTE group demonstrated lower concordance (κ = 0.761). Macro average sensitivity and specificity were 95.8% and 98.8% for the TTE-only group, compared to 83.9% and 97.1% for the combined MSCT + TTE group. The lower concordance observed in the combined imaging group likely reflects the greater anatomical complexity of patients selectively referred for adjunctive MSCT imaging. <b>Conclusions:</b> TTE demonstrated stronger agreement with intraoperative surgical findings (κ = 0.93), whereas the combined MSCT + TTE group demonstrated lower concordance (κ = 0.761). The lower concordance observed in the combined imaging group likely reflects the greater anatomical complexity of patients selectively referred for adjunctive MSCT imaging.
KW  - Double outlet right ventricle; multislice computed tomography; transthoracic echocardiogram; ventricular septal defects

DO  - 10.32604/schd.2026.083109