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.
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Epidemiology
Associations
- ventricular septal defect
- subpulmonic and subaortic obstruction
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:
- abnormal origin of the pulmonary artery from the left ventricle,
- VSD defect, and
- aortic-anterior mitral valve leaflet continuity
Differential diagnosis
In the absence of pulmonic stenosis consider:
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