DOUBLE OUTLET LEFT VENTRICLE (DOLV)

DOLV is a malformation in which the aorta and pulmonary artery arise predominantly or exclusively from the left ventricle.

CLASSIFICATION

The classification of DOLV is based on the following criteria:

1. The situs of the atria:
• Situs solitus (normal).
• Situs inversus.
• Situs ambiguous.
2. The alignment of the atria, ventricles and great vessels:
• Concordant or discordant alignment.
• Double inlet.
• Absent left or right atrioventricular connection.
3. Location of the VSD or other associated cardiovascular anomalies:
• Subaortic VSD (48%).
• Subpulmonic VSD (15%).
• Subaortic and subpulmonic VSD (very rare).
• Remote or noncommitted VSD.

ULTRASOUND

• Aorta and pulmonary artery are committed by >50% to the left ventricle
• Orientation of the great vessels:
• Side by side with the right and lateral to the pulmonary artery (most common presentation with the vessels parallel to each other).
  The vessels are circular and parallel on the short axis view (normally the pulmonary artery is perpendicular to and drapes over the aorta). This may appear similar to d-TGA however both vessels originate from one ventricle).
• VSD (usually subaortic). Multiple VSD's may occur.
• Pulsed and color doppler is used to exclude aortic or pulmonary artery stenosis / atresia, or coarctation of the aorta.
• The atrioventricular valves require close assessment.

ASSOCIATED CONDITIONS AND SYNDROMES

Link to Associated Conditions and Syndromes