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DCLV is characterized by the presence of two LV-chambers, oriented in parallel and must be distinguished from a LV-diverticulum by the presence of an additional contractile septum.A 56-years-old female with severe aortic stenosis was referred to cardiac computed tomography angiography (CTA) for planning of transcatheter aortic valve implantation (TAVI).She had undergone surgical closure of a membranous ventricular septal defect (VSD), and pulmonary banding with debanding 8 years later.Echocardiography reported muscular VSDs with hypertrabeculations ("swisscheese"-pattern) and almost-total closure with possible minimal residual shunt.Cardiac CTA showed an unusual left ventricle (LV) consisting of two chambers with apexes oriented parallel anteriorly oblique (Fig. 1), and excessive LV-hypertrabeculation apical and midventricular septal (mid panel) mimicking a muscular VSD midseptal.TAVI was deferred to avoid the risk of wire trapping and LV-perforation.She underwent mechanical aortic valve replacement (21 mm On-X™ prosthesis) and patch repair of the residual pulmonary stenosis.The small residual VSD reported by echocardiography could not be located intraprocedural. 1 year follow-up was uneventful.Double-chambered left ventricle (DCLV) is extremely rare (estimated prevalence 0.04-0.42%)-although the exact prevalence is unknown and most commonly involving the right ventricle, while the incidence left is even scarcer with only few cases reported worldwide.
Lacaita et al. (Fri,) studied this question.