Bi-ventricular repair of Double Outlet Left ventricle - Experience and
Review of Literature
Abstract
Double-outlet left ventricle (DOLV) is a rare congenital cardiac
anomaly. The aorta and the main pulmonary arterial trunk arises
predominantly from the left ventricle(LV) and is associated with a
malaligned ventricular septal defect(VSD), various degrees of hypoplasia
of the right ventricle, and presence or absence of pulmonary stenosis.
Bi-ventricular repair is the preferred treatment option whenever
possible. Various techniques for bi-ventricular repair have been
described. The best option for DOLV correction is by translocating the
pulmonary root to the right ventricle(RV)[1]. In this series, we
report four patients who underwent biventricular repair of DOLV in our
institute with excellent outcomes. All patient details were collected
from the institute patient record system. Echocardiographic data were
obtained from the records. Intraoperative charts were reviewed for
further information on the surgical procedure and cardiopulmonary
bypass. Postoperative data included survival, functional status and
followup echocardiography. Of the four children, three underwent
pulmonary root translocation and one child underwent Reparation al etage
Ventriculaire(REV) procedure. There was no mortality and all children
are in stable clinical condition in the recent follow-up and no
re-operations or interventions were required following primary surgical
correction. Thus DOLV is anatomically and surgically a challenging
subset. Pulmonary root translocation in this anatomy is technically
challenging but safe and superior option when compared to other
alternative surgical procedures and it can be performed with excellent
results, even in infants.