A one-year-old boy thought to have Tetralogy of Fallot is found on cardiac catheterization to have double-outlet right ventricle (DORV). The follow is/are true:

a. Spontaneous closure of the VSD is rare

e. Doubly committed VSD refers to its relationship to the great vessels

In DORV, the location of the VSD affects the direction of flow of oxygenated blood and thus determines the degree of cyanosis. Fortunately, the VSD rarely closes since that would result in severe decompensation or death. Double outlet left ventricles occur but are less common than DORV. A number of other anomalies are associated with DORV including both valvar and subvalvar pulmonary and aortic stenosis. The VSD may be directed to either or both great vessels (doubly committed) or remote from them (noncommitted).