Double Outlet Left Ventricle

Abstract

Most of us will encounter few, if any, patients with double outlet left ventricle (DOLV), but the significant anatomic variation requires an understanding of a broad spectrum of pathophysiology. This ranges from a lesion similar to that of a tetralogy of Fallot (TOF)-type DORV, with a pulmonary outflow obstruction that may be dynamic in nature, to that of left-sided obstructive lesions and pulmonary overcirculation. Here we review the anatomic and physiologic considerations of managing these patients and frame the chapter with clinical vignettes to highlight anesthetic management goals.