Double outlet left ventricle (DOLV)

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.

Epidemiology

Associations

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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