Double outlet left ventricle
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.
- ventricular septal defect
- subpulmonic and subaortic obstruction
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.
It demonstrates the abnormal origin of the pulmonary artery from the left ventricle, normal aortic-mitral continuity, and VSD.
It will demonstrate:
- abnormal origin of the pulmonary artery from the left ventricle,
- the VSD defect, and
- aortic-anterior mitral valve leaflet continuity.
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.
congenital heart disease
- normal relationship between chambers and valves
- atrioventricular valves
- outflow tract
- great vessels
- venous inflow
- anomalous valves
- abnormal relationship of chambers and valves
- atrioventricular abnormality
- great vessel connection abnormality
- conotruncal cardiac anomalies
- pentalogy of Cantrell
- Shone syndrome
- congenital heart disease - chest x-ray approach
surgical repairs (mnemonic)
- arterial switch procedure
- Blalock-Taussig shunt
- double switch procedure
- Fontan procedure
- Glenn procedure
- Mustard repair
- Norwood procedure
- Pott shunt
- pulmonary artery banding
- Rastelli procedure
- Sano shunt
- Senning repair
- total repair of tetralogy of Fallot (TOF)
- unifocalisation procedure
- Waterston shunt