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Abstract
In double outlet left ventricle, both the pulmonary artery and the aorta arise from
the morphologic left ventricle. This paper presents the anatomic and cineangiocardiographic
features of five patients who had this condition proved at surgery or autopsy. The
condition of the first patient was incorrectly diagnosed as transposition of the great
arteries with pulmonary stenosis and ventricular septal defect; the anatomic features
were correctly interpreted at operation in 1966 and appropriate repair was made, but
the patient died postoperatively. The condition of the other four patients was correctly
diagnosed. The second patient had Ebstein's malformation of the tricuspid valve and
hypoplastic right ventricle in addition to double outlet left ventricle; her condition
was not considered operable. Two patients, one with visceroatrial situs solitus, concordant
d-loop and dextrocardia, were surgically treated with good long-term results. The fifth
patient died 2 years postoperatively and is the first patient reported to have double
outlet left ventricle with visceroatrial situs inversus, a discordant d-loop and levocardia.
The segmental approach to the classification and diagnosis of connection disorders
is discussed and the radiologic criteria by which double outlet left ventricle may
be diagnosed considered in detail. The importance of using the radiologic projection
(usually left anterior oblique) that profiles the ventricular septum is emphasized
because the diagnosis can be established only by delineating the relations of the
origins of the great arteries to the ventricular septum. The surgical significance
of other anatomic features, including the number, size and position of ventricular
septal defects and conal malformations, is also discussed.
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References
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Article Info
Publication History
Accepted:
March 18,
1976
Received in revised form:
March 15,
1976
Received:
November 20,
1975
Identification
Copyright
© 1976 Published by Elsevier Inc.
