Assessment of Double Outlet Left Ventricle in Pediatrics Using Transthoracic Echocardiography and Computed Tomographic Angiography

Double outlet left ventricle (DOLV) is a rare congenital cardiac anomaly in which both great arteries originate entirely or predominantly from the morphologic left ventricle. The aim of this study is to explore its clinical presentations and compare the diagnostic accuracy of transthoracic echocardiography (TTE) with computed tomographic angiography (CTA) on DOLV. We took TTE as a first-line examination modality, considering CTA and surgical results as the gold standard. Ten suspected patients with DOLV were identified at the Children's Hospital of Chongqing Medical University from March 2009 to November 2023. The clinical presentations, TTE, CTA, and follow-up data of the children were analyzed retrospectively. All 10 cases (100%) underwent TTE examination, and 7 patients (70%) received CTA examination. Six patients (60%) ultimately underwent surgery and were confirmed to have DOLV. DOLV were initially diagnosed using TTE with a diagnostic accuracy rate of 85.71% after comparisons with CTA and surgery results. Ventricular septal defect (100%) and atrial septal defect (80%) were the common associated abnormality. The clinical manifestation of DOLV was atypical, and TTE has a relatively high diagnostic accuracy for DOLV in pediatrics, making it a very valuable tool for early detection.