OVERRIDING AORTA – CAUSES

AND RISKS

WHAT IS OVERRIDING AORTA ?

An overriding aorta is a congenital heart defect where the aorta
is positioned directly over a ventricular septal defect, instead of
over the left ventricle. The result is that the aorta receives some
blood from the right ventricle, which reduces the amount of
oxygen in the blood.

Fetal endocardiogram showing the aortic valve

overriding aorta
CAUSES

Because of the displacement of the malaligned outlet septum

into the right ventricle, the aortic root, of necessity, overrides
the muscular ventricular septum. In the setting of significant
subpulmonary obstruction, shunting across the interventricular
communication is predominantly from right-to-left, which
promotes ejection of deoxygenated blood into the systemic
circulation. The chronic volume load sustained by the
overriding aorta is implicated in the dilation of the aortic root
noted in adults with tetralogy of Fallot.

 
Overriding aorta is a result of the displacement of the outlet
septum into the right ventricle, which causes the aortic root to
be positioned directly over the VSD.

MRI left anterior oblique with VSD and overriding aorta

Heredity may play a role in causing tetralogy of Fallot. An adult
who has tetralogy of Fallot may have an increased chance of
having a baby with the condition.

The specific cause of tetralogy of Fallot isn't always known. The

TOF changes in a baby's heart develop in the early weeks of
pregnancy. In some cases, there are genetic causes of TOF —
for example, children with Down syndrome or DiGeorge
syndrome are more likely to have TOF. Someone born with TOF
is more likely to have a child or sibling with it. Each year,
roughly 1 out of every 2,500 babies born in the United States
have the condition.
 RISKS 

Several risk factors have been associated with the condition.

These include:
 maternal alcoholism
 diabetes
 maternal age that’s over 40
 poor prenatal diet

People with TOF often have other congenital disorders such as

Down syndrome.

Certain conditions or factors that occur during pregnancy may

raise your risk for having a child with tetralogy of Fallot. These
conditions and factors include:
 German measles (rubella) and some other viral illnesses
 Poor nutrition
 Overuse of alcohol
 Age (being older than 40)
 Diabetes

(Rubella)
  Babies of mothers who get rubella (German measles) or
other viral illnesses during their pregnancies are at a
higher risk for TOF. Other pregnancy-related risks include
poor nutrition, alcohol abuse, poorly controlled diabetes,
and the mother's age (over 40). Certain environmental
factors, such as air pollution, also may increase a mother's
chances of having a baby with TOF.
 Children born to mothers with PKU are highly susceptible
as are mothers who drink during birth . Most of the time, a
child with TOF doesn't have any other birth defects. No
one is really sure why this occurs.

Graph:

Historgram demostrating the range of aortic

override using the linear method