The morphologic spectrum of double outlet left ventricle and its surgical significance

S Bharati, M Lev, R Stewart, H A McAllister, J W Kirklin
1978 Circulation  
16. McMullan MH, Wallace RB, Weidman WH: Surgical treatment of complete atrioventricular canal. Surgery 72: 905, 1972 17. Lev M: The architecture of the conduction system in congenital heart disease. 1. Common atrioventricular orifice. Arch Pathol 65: 174, 1958 18. Feldt RH. DuShane JW, Titus JL: The atrioventricular conduction system in persistent common atrioventricular canal defect: correlations with the electrocardiogram. D)ouble outlet left ventricle (1DOLV) is defined in this paper as
more » ... condition in which both great arterial %essels emerge completely (complete form) or mostly (incomplete form)-from the morphologic left ventricle. This is a study of eight cases diagnosed during surgery and 37 cases diagnosed at autopsy. DOLV was classified as follows: 1) with the aorta to the right, or to the right and posterior to the pulmonary trunk: a) with ventricular septal defect (VSD) confluent with the aorta e 10 cases), b) with VSD confluent with the pulmonary trunk (three cases), and c) with VSD confluent with both vessels (two cases). 2) with aorta anterior to, anterior and to the right, or anterior and to the left of the pulmonary trunk: a) vvith the VSI) related to the aorta (10 cases), b) with the VSD related to the pulmonary trunk (one case), and c) with the 'Sil) related to both vessels (two cases). 3) with tricuspid valve abnormalities: a) with tricuspid atresia and stenosis with normalls related vessels (four cases), or aorta anterior (10 cases), b) with straddling or displaced tricuspid valve (two cases), or C> with Ebstein's anomaly (one case). Five surgical and four autopsied cases were of the complete form. From the surgical standpoint, it is important in DOLV to determine the interrelationship and origin of the great arteries, their relationship to the 'Si), and the location of the VSD in the ventricular septum. The presence of tricuspid valve abnormalities is emphasized.
doi:10.1161/01.cir.58.3.558 pmid:679448 fatcat:m73u52cabrcupbie4nugz6ckye