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Double outlet from chambers of left ventricular morphology
Insights
Double outlet of the left ventricle is a rare congenital heart defect found in 0.23% of specimens. Accurate diagnosis is crucial for surgical correction, especially when abnormal atrioventricular connections are present.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Pediatric Cardiology
Background:
- Double outlet of the left ventricle (DOLV) is a complex congenital heart anomaly.
- Accurate diagnosis and understanding of associated defects are critical for patient management.
Purpose of the Study:
- To report a series of 5 cases with double outlet of the left ventricle.
- To highlight diagnostic challenges and the importance of detailed anatomical assessment for surgical planning.
Main Methods:
- Review of 1700 heart specimens to determine incidence.
- Analysis of one surgically corrected case.
- Discussion of diagnostic modalities, including axial cineangiography.
Main Results:
- An incidence of 0.23% for DOLV was identified in the reviewed specimens.
- Four of the five cases had abnormal atrioventricular connections precluding total correction.
- Frequent findings included absence of the infundibular septum and aortic laevoposition.
Conclusions:
- Clinical diagnosis of DOLV can be challenging.
- Axial cineangiography may aid in anatomical diagnosis.
- Detailed assessment of ventricular size, atrioventricular valves, VSD, and outflow tract obstruction is essential for surgical consideration.
Abstract:
This series of 5 cases with double outlet of morphologically left ventricular chamber includes 4 found during a review of 1700 heart specimens (incidence 0.23%) and 1 found at operation and successfully corrected. Abnormal atrioventricular connection precluding total correction was present in the 4 anatomical cases. Clinical diagnosis may be difficult and it is suggested that axial cineangiography may make anatomical diagnosis easier. Absence of the infundibular septum and aortic laevoposition are frequent. As some cases can be surgically corrected, accurate information is required on the size of the right ventricle, the morphology and function of the atrioventricular valves, the presence, size, and position of the ventricular septal defect, and the degree and type of outflow tract obstruction.