In 11 cases of double inlet left ventricle, patients presented with cyanosis when pulmonary stenosis was present and with congestive cardiac failure when it was absent.
Case Report (n=11)
This case series describes the anatomical variations, clinical presentations, and diagnostic features of double inlet left ventricle and straddling tricuspid valve.
Eleven cases of double inlet left ventricle have been presented.Double inlet left ventricle is characterized by the tricuspid valve opening partly (partial type) or completely (complete type)into the morphological left ventricle.The morphological right ventricle is usually hypoplastic but may be normally formed.Even when the right ventricle is hypoplastic, both the sinus and the outflow portions of the right ventricle are recognizable.Double inlet left ventricle has been classified into two groups according to whether the ventricles are nor- mally placed (noninverted; concordant with the atria) or inverted (discordant with the atria.)This classification indicates the anatomical relation of the atrioventricular valves and the ventricles.When the ventricles are non- inverted, a right-to-left shunt results from the communication of the right atrium with the left ventricle.On the other hand, with inverted ventricles a left-to-right shunt results from the left atrium communicating with the inverted left ventricle.Further details in circulation depend upon the great vessel-ventricular relations.Clinically, the patients presented with cyanosis when pulmonary stenosis was present and with congestive cardiacfailure when pulmonary stenosis was absent.The electrocardiogram is helpful in suggesting the presence of inverted or noninverted ventricles.Right and left atriograms are essential for the diagnosis of straddling tricuspid valve in noninverted and in inverted ventricles, respectively.Straddling tricuspid valve is an anomaly wherein the tricuspid valve overrides the ventricular septum and communicates with both ventricles.This con- dition may be considered as one form of double inlet left ventricle.In another form of the latter condition the tricuspid valve opens entirely into the left ventricle, as does the mitral valve.The sub- ject of double inlet left ventricle and straddling tricuspid valve have received major attention only in recent years.The subject is somewhat complex in that variations in the positions of the ventricles and of the great arteries may be associated and mitral atresia may be present.Because of the foregoing and the fact that a lim- ited number of cases have been reported, it appears
Tandon et al. (1974) conducted a case report in Double inlet left ventricle and straddling tricuspid valve (n=11). Double inlet left ventricle was evaluated. In 11 cases of double inlet left ventricle, patients presented with cyanosis when pulmonary stenosis was present and with congestive cardiac failure when it was absent.