Double outlet left ventricle

Dr Aditya Shetty et al.

Double outlet left ventricle (DOLV) is an extremely rare congenital cardiac anomaly where both the aorta and pulmonary trunk arise from the anatomical left ventricle. It is usually classified as a conotruncal anomaly and is often associated with a ventricular septal defect with normal continuity between the aortic valve and anterior mitral valve. Other associated defects are a subpulmonic and subaortic obstruction. 

Associated conditions

Radiographic features

Plain radiograph

Chest radiographic features relate to the presence or absence of pulmonic valvular stenosis.

  • in the presence of pulmonic stenosis, findings are similar to tetralogy of Fallot with a normal heart size and decreased pulmonary flow.
  • without pulmonic stenosis, moderate cardiomegaly and increased pulmonary blood flow are evident. 
Echocardiography

It demonstrates the abnormal origin of the pulmonary artery from the left ventricle, normal aortic-mitral continuity, and VSD.

Angiocardiography

 It will demonstrate: 

  1. abnormal origin of the pulmonary artery from the left ventricle,
  2. the VSD defect, and
  3. aortic-anterior mitral valve leaflet continuity. 

Differential diagnosis

In the absence of pulmonic stenosis consider:

 


Congenital heart disease

There is more than one way to present the variety of congenital heart diseases. Whichever way they are categorised, it is helpful to have a working understanding of normal and fetal circulation, as well as an understanding of the segmental approach to imaging in congenital heart disease.

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Article Information

rID: 29696
Tags: shetty, refs, cases
Synonyms or Alternate Spellings:
  • Double outlet left ventricle (DOLV)
  • DOLV

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