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Di Gioia G, Buzzelli L, Segreti A. Left ventricular inferior wall congenital diverticula in athletes: a case series and review of the literature. Eur Heart J Case Rep 2024; 8:ytae036. [PMID: 38313323 PMCID: PMC10834112 DOI: 10.1093/ehjcr/ytae036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/21/2023] [Accepted: 01/19/2024] [Indexed: 02/06/2024]
Abstract
Background Congenital left ventricular diverticula (LVDs) and aneurysms (LVAs) are rare, developmental, cardiac anomalies, which are often asymptomatic. Sometimes they can cause life-threatening complications like arrhythmias, syncope, embolic events, ventricular wall rupture, valvular regurgitation, congestive heart failure, and various symptoms. Diagnosis is usually made after exclusion of acquired causes, from cardiac or non-cardiac disorders. Specific guidelines for LVD/LVA management are not available and treatment options are guided by different case-by-case clinical presentation and possible complications. Case summary We present a series of two patients with occasional diagnosis of diverticula of the inferior basal left ventricular wall in the context of cardiological evaluations for competitive sport certificate. Symptoms were present at clinical evaluation only in Patient 1, together with electrocardiogram (ECG) abnormality. We performed transthoracic echocardiography as a first-line examination and secondly, we confirmed the diverticula by cardiac magnetic resonance. A maximal stress test and 24 h ECG Holter were also performed.In our case, in light of the clinical-instrumental findings, periodic medical and echocardiographic follow-up without therapy was established, together with the resumption of sports activities. Discussion Nowadays, no specific recommendations exist in athletes and no studies are available on how regular sport practice can influence natural history of LVD/LVA. The current case series highlights the importance of risk stratification for cardiac events, of a multimodal imaging approach in diagnostic procedure and of a tailored treatment strategy.
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Affiliation(s)
- Giuseppe Di Gioia
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1–00197 Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Campus Bio-Medico, Via Alvaro del Portillo, 200–00128 Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome ‘Foro Italico’, Piazza Lauro De Bosis, 15–00135 Rome, Italy
| | - Lorenzo Buzzelli
- Department of Cardiovascular Sciences, Fondazione Policlinico Campus Bio-Medico, Via Alvaro del Portillo, 200–00128 Rome, Italy
| | - Andrea Segreti
- Department of Cardiovascular Sciences, Fondazione Policlinico Campus Bio-Medico, Via Alvaro del Portillo, 200–00128 Rome, Italy
- Department of Movement, Human and Health Sciences, University of Rome ‘Foro Italico’, Piazza Lauro De Bosis, 15–00135 Rome, Italy
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2
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Fang Y, Pan Y, Shen L, Luo T, Xu W, Tao S, He H, Zhao B. Prenatal features and postnatal follow-up of congenital ventricular outpouching: A retrospective study of two centers in China. Echocardiography 2024; 41:e15747. [PMID: 38284682 DOI: 10.1111/echo.15747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/07/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVES Congenital ventricular outpouching (CVO) is a rare cardiac malformation that can manifest as congenital ventricular aneurysm (CVA) and/or congenital ventricular diverticula (CVD). In this study, we describe the prenatal features and postnatal follow-up of 27 cases of CVO. METHODS The clinical data of 27 patients with CVO who attended Sir Run Run Shaw Hospital Affiliated to the Medical College of Zhejiang University (Zhejiang Province, China) and Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University (Zhejiang Province, China) from April 2013 to October 2022 were retrospectively analyzed. The patients were also followed up by telephone. The prenatal characteristics and postnatal outcomes of the patients with CVO were evaluated. RESULTS CVO was detected in 26 cases prenatally, 14 (51.85%) were diagnosed with CVA, nine (33.33%) were diagnosed with CVD, three (11.11%) were equivocal for CVA/CVD, and one (3.70%) was detected with CVA postnatally. Six patients underwent follow-up fetal echocardiography approximately 4 weeks after the initial echocardiography examination, and a significant difference in CVO size was observed between the two examinations (P = .02). Eight patients (29.63%) demonstrated cardiovascular dysfunction, and the median CVO size in fetuses with and without cardiovascular dysfunction was 205 (range: 169-396) mm2 and 124 (range: 92-154.5) mm2 , respectively (P = .01). Correlation was found between CVO size and fetal cardiac dysfunction (p = .000, r = .778). Eight patients (29.63%) had cardiac/extracardiac defects. Thirteen patients were live born, 12 were terminated pregnancies, and two were lost to follow-up. The postpartum size of the CVOs remained stable in six patients, decreased in two patients, dissolved in three patients, and were surgically removed in two patients. With the exception of one patient with CVA complicated with complex congenital cardiac malformation who underwent surgical treatment after birth and who had postoperative left ventricular dysfunction (Case 1), the prognosis of all of the patients was good. CONCLUSION CVO is often associated with cardiac malformations. The size of prenatal CVOs can increase with gestational development, and cardiovascular dysfunction is significantly related to CVO size. The postpartum prognosis of patients with CVO is good. Echocardiography plays a key role in the diagnosis of congenital ventricular outpouching. Prenatal counseling should be cautious regarding the diagnosis and the prognosis although our cases had a favorable prognosis.
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Affiliation(s)
- Yanchun Fang
- Department of Ultrasound Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Yihong Pan
- Department of Obstetrics and Gynecology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Liping Shen
- Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Ting Luo
- Department of Ultrasound Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Weiming Xu
- Department of Pathology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Shuangshuang Tao
- Department of Ultrasound Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Hailing He
- Department of Ultrasound Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Bowen Zhao
- Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China
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3
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Bekheet S, Al-Radi OO, Abou Zahr R. Congenital giant left ventricular aneurysm. Cardiol Young 2023; 33:1203-1205. [PMID: 36484134 DOI: 10.1017/s1047951122003651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We report a case of congenital giant left ventricular aneurysm with severely depressed systolic cardiac function who underwent early surgical resection with subsequent recovery of left ventricular systolic function.
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Affiliation(s)
- Samia Bekheet
- Pediatric Cardiology Section, Pediatric Department, King Faisal Specialist Hospital and Research Center, 2572 Ar-Rawdah, Jeddah23433-7154, Saudi Arabia
| | - Osman O Al-Radi
- Cardiovascular Surgery Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Riad Abou Zahr
- Pediatric Cardiology Section, Pediatric Department, King Faisal Specialist Hospital and Research Center, 2572 Ar-Rawdah, Jeddah23433-7154, Saudi Arabia
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4
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Ali MW, Siddharth, Husain SM, Desai N. Double chambered left ventricle-institutional experience of two cases. J Card Surg 2022; 37:5480-5484. [PMID: 36168814 DOI: 10.1111/jocs.16966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Double Chambered Left Ventricle is a very rare congenital cardiac condition with limited cases reported in literature, etiology of which is obscure and presentation can be varied. AIM OF THE STUDY To share our experience of two diverse cases of Double Chambered Left Ventricle at our institute. RESULTS Two diverse cases of Double Chambered Left Ventricle were appropriately diagnosed and successfully managed. One of which one was congenital and the other was acquired METHODS: Both the patients had an uneventful peri-operative period. CONCLUSIONS Double Chambered Left Ventricle is a condition which remains an enigma. Diagnosis requires a high degree of radiological suspicion for prompt diagnosis and good surgical outcomes.
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Affiliation(s)
- Mohammed Wahaj Ali
- Department of CardioThoracic and Vascular Surgery, Sri Sathya Sai Institute of Higher Medical Sciences, Anantapur, India
| | - Siddharth
- Department of CardioThoracic and Vascular Surgery, Sri Sathya Sai Institute of Higher Medical Sciences, Anantapur, India
| | - Shaikh M Husain
- Department of CardioThoracic and Vascular Surgery, Sri Sathya Sai Institute of Higher Medical Sciences, Anantapur, India
| | - Neelam Desai
- Department of CardioThoracic and Vascular Surgery, Sri Sathya Sai Institute of Higher Medical Sciences, Anantapur, India
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5
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Submitral aneurysm communicating with coronary sinus in a child. Cardiol Young 2022; 32:1149-1150. [PMID: 35292123 DOI: 10.1017/s104795112100442x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A newborn girl was referred for a suspected abnormal pulmonary venous return in coronary sinus. Echocardiogram revealed a large outpouching of the left ventricle creating an accessory cardiac chamber that was connected to the left ventricle behind the mural leaflet of the mitral valve, and with the right atrium via the coronary sinus. Ten years later, the orifice between the submitral aneurysm and the left ventricle was closed percutaneously.
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6
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Luc TQ, Hien PD, Ninh TP, Lan LTM, Van Hung N, Van Ngoc D, Van Kien N, Van Sang N. Left ventricular diverticulum: A case report and review of the literature. Radiol Case Rep 2022; 17:2717-2722. [PMID: 35669224 PMCID: PMC9166412 DOI: 10.1016/j.radcr.2022.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022] Open
Abstract
Left ventricular diverticulum is a rare congenital left ventricular outpouchings. The disease is often diagnosed during childhood because it is frequently associated with midline thoracoabdominal defects and other congenital cardiac anomalies. Most cases are asymptomatic, often discovered incidentally. Some complications have been reported including infarction, arrhythmia, heart failure. The most severe complication is rupture of the diverticulum, which can cause a patient's death. Therefore, this congenital defect should be detected early to assess potential risks for appropriate treatment. In this article, we report a case of a 3-month-old boy with left ventricular diverticulum diagnosed with Doppler ultrasound and cardiac MSCT. Complete resection was undertaken. The patient remained asymptomatic with good heart function 2 months after surgery.
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Affiliation(s)
- Tran Quang Luc
- Department of Radiology, Viet Tri general hospital, Phu Tho, Vietnam
| | - Pham Duy Hien
- Department of Radiology, Vietnam National Children's Hospital, Ha Noi, Vietnam
| | - Tran Phan Ninh
- Department of Radiology, Vietnam National Children's Hospital, Ha Noi, Vietnam
| | - Le Thi Mai Lan
- Department of Radiology, Vietnam National Children's Hospital, Ha Noi, Vietnam
| | - Ngo Van Hung
- Department of Radiology, Vietnam National Children's Hospital, Ha Noi, Vietnam
| | - Doan Van Ngoc
- Department of Radiology, VNU University of Medicine and Phamarcy, Ha Noi, Vietnam
| | - Nguyen Van Kien
- Department of Radiology, Viet Tri general hospital, Phu Tho, Vietnam
| | - Nguyen Van Sang
- Department of Radiology, E Hospital, Ha Noi, Vietnam.,Department of Radiology, Medlatec Hospital, Ha Noi, Vietnam.,Department of Radiology, Thai Nguyen Pharmacy and Medical University, Thai Nguyen, 250000, Vietnam
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7
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Lagerstrand K, Svensson PA, Andersson L, Synnergren M, Öhman A, Petersson M, Sunnegardh J, Dangardt F. Treatment decision in a 4-year-old-boy with left ventricular outpouching after advanced hemodynamical flow evaluation with 4Dflow CMR: A case report. Front Pediatr 2022; 10:953770. [PMID: 36467479 PMCID: PMC9714534 DOI: 10.3389/fped.2022.953770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The present study presents a diagnostic course for the characterization of a congenital left ventricular outpouching (LVO) in a 4-year-old boy with severe neonatal heart failure, evaluating the added value of cardiac magnetic resonance (CMR) 4Dflow. CASE PRESENTATION A boy, born at full term, presented with heart failure immediately after birth. Echocardiography showed dilated left ventricle with poor function and LVO was initially interpreted as an aneurysm. No infection, inflammation, or other cause for heart failure was found. With intensive medical treatment, the heart function returned to normal, and eventually, all medication was terminated. At follow-up, surgical treatment of the LVO was discussed but after CMR 4Dflow, a thorough evaluation of the function of the left ventricle as well as the LVO was possible and the LVO was determined a double-chambered left ventricle with a good prognosis. CONCLUSIONS The present case demonstrates the clinical usability of CMR 4Dflow for improved decision-making and risk assessment, revealing advanced hemodynamic flow patterns with no need for operation.
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Affiliation(s)
- Kerstin Lagerstrand
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Par-Arne Svensson
- Department of Pediatric Radiology and Physiology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linnea Andersson
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mats Synnergren
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Pediatric Cardiology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Annika Öhman
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Pediatric Cardiology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Magnus Petersson
- Department of Pediatric Cardiology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jan Sunnegardh
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Pediatric Cardiology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Frida Dangardt
- Department of Pediatric Cardiology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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8
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Rocha-Arrieta MC, Arias-Díaz A, Soto Zárate EF, Vergara Vergara GE, Aristizábal Villa GJ, Brochet Bayona GA. [Ventricular diverticulum in Cantrell´s pentalogy: rare but not isolated entities]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2021; 2:263-267. [PMID: 37727665 PMCID: PMC10506561 DOI: 10.47487/apcyccv.v2i4.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/05/2021] [Indexed: 09/21/2023]
Abstract
Pentalogy of Cantrell is a rare entity characterized by a combination of alterations, among which the following stand out: defects of the pericardium, heart, diaphragm, lower third of sternum and abdominal wall. On the other hand, congenital cardiac diverticulum is a rare malformation whose presentation is associated with Cantrell's pentalogy in some cases. We present the case of a child with Cantrell's pentalogy who, during follow-up, was diagnosed with left ventricular diverticulum, which required surgical management with a favorable outcome. Addressing these conditions requires the use of cardiovascular images that allow timely decision-making by the treating team.
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Affiliation(s)
| | - Antonio Arias-Díaz
- Unidad de Cuidados Intensivos Pediátricos Doña Pilar. Cartagena, Colombia. Unidad de Cuidados Intensivos Pediátricos Doña Pilar Cartagena Colombia
| | - Enrique Felipe Soto Zárate
- Universidad de Cartagena. Cartagena, Colombia. Universidad de Cartagena Universidad de Cartagena Cartagena Colombia
| | - Gabriel Elias Vergara Vergara
- Centro Diagnóstico de Imágenes y Radiología. Cartagena, Colombia. Centro Diagnóstico de Imágenes y Radiología Cartagena Colombia
| | | | - Gustavo Adolfo Brochet Bayona
- Hospital Infantil Napoleón Franco Pareja. Cartagena, Colombia Hospital Infantil Napoleón Franco Pareja Cartagena Colombia
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9
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Bao SF, Wu LJ, Zhang YQ, Hong WJ, Chen LJ, Wang Q. Diagnosis of Double-chambered Left Ventricle of Superior-inferior Type by Echocardiography: A Retrospective Study of 9 Subjects across Two Heart Centers. Echocardiography 2020; 38:169-174. [PMID: 33368575 DOI: 10.1111/echo.14939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Double-chambered left ventricle (DCLV) is extremely rare. Challenges remain in accurate diagnosis of DCLV by echocardiography, because it is easily confused with left ventricular diverticulum, left ventricular aneurysm, ventricular septal defect, etc. Herein, we reviewed echocardiographic characteristics of DCLV and evaluated the accuracy of echocardiographic diagnosis. METHODS Clinical and echocardiographical databases of two heart centers were reviewed. Nine children with DCLV of superior-inferior arrangement were studied retrospectively. RESULTS Normal elliptical geometry of LV cavity is preserved in DCLV. Fibromuscluar bundles separate LV into the main chamber and the accessory chamber. The associated malformations included ventricular septal defects, mitral regurgitation, mitral valve stenosis, pulmonary stenosis, and left ventricular noncompaction in our study. Eight of nine subjects with DCLV of superior-inferior arrangement were diagnosed correctly by initial echocardiographic examination, and one case was mistaken as left ventricular diverticulum. CONCLUSIONS Double-chambered left ventricle could be diagnosed and followed up by echocardiography. The morphological classification is a simplified way to improve diagnostic accuracy.
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Affiliation(s)
- Sheng-Fang Bao
- Department of Pediatric Cardiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Li-Jun Wu
- Department of Echocardiography, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu-Qi Zhang
- Department of Pediatric Cardiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen-Jing Hong
- Department of Pediatric Cardiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Li-Jun Chen
- Department of Pediatric Cardiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qian Wang
- Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
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10
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Tsaruk O, Ryzhyk V, Ilnytska K. Congenital Aneurysm/Diverticulum of the Left Ventricle in the Newborn. GALICIAN MEDICAL JOURNAL 2020. [DOI: 10.21802/gmj.2020.4.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Left ventricular aneurysms and diverticula are severe congenital heart defects. The low prevalence and mostly asymptomatic course of these anomalies do not always allow us to suspect these defects in time and to differentiate them among themselves. That is why early detection of pathology with the help of fetal echocardiography is a key factor in determination of the tactics of patients’ management. The paper reviews the literature and describes a complex case of prenatally diagnosed left ventricular aneurysm.
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11
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Two in One: Echocardiographic Features of Right-Ventricular Diverticulum and Left-Ventricular Aneurysm in the Same Patient. CJC Open 2020; 2:719-721. [PMID: 33305237 PMCID: PMC7711003 DOI: 10.1016/j.cjco.2020.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/27/2020] [Indexed: 11/20/2022] Open
Abstract
Ventricular diverticulum is a rare congenital heart defect that is usually found incidentally upon imaging, such as 2-dimensional transthoracic echocardiogram. We report a case in which an isolated right-ventricular diverticulum and a left-ventricular aneurysm were both found on transthoracic echocardiogram in the setting of a pulmonary embolism. This case highlights how to distinguish between an aneurysm and a diverticulum based on wall motion on echocardiogram, as well as potential complications that may arise from either anomaly.
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12
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A Japanese Patient with Genitopatellar Syndrome Transiently Presenting with Cardiac Intramural Cavity during the Neonatal Period. Case Rep Genet 2020; 2020:1731720. [PMID: 32908725 PMCID: PMC7475762 DOI: 10.1155/2020/1731720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 08/23/2020] [Indexed: 12/02/2022] Open
Abstract
Genitopatellar syndrome (GPS) is a rare autosomal dominant disorder caused by de novo pathogenic variants in the KAT6B gene. It is characterized by genital abnormalities, patellar hypoplasia/agenesis, flexion contractures of the hips and knees, corpus callosum agenesis with microcephaly, and hydronephrosis and/or multiple renal cysts. More than half of patients with GPS have congenital heart defects, mostly atrial and/or ventricular septal defects, patent foramen ovale, and patent ductus arteriosus. We report a case of a Japanese neonate with a de novo heterozygous c.3769_3772delTCTA pathogenic variant in the KAT6B gene who presented with a cardiac intramural cavity of the ventricular septum at birth. The cavity unexpectedly disappeared at 1 month of age, but trabecular septal thinning and flash remained. The features of the cavity were not consistent with those of congenital ventricular diverticulum or aneurysm, and its identity and prognosis are still unclear. Because patients with GPS may exhibit various forms of cardiac malformation, careful cardiac examination and follow-up are required from birth in cases of suspected GPS.
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13
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Fang Y, An Q, Yu T, Luo S. Partial resection of large congenital left ventricular diverticulum in an infant: a case report. BMC Surg 2020; 20:146. [PMID: 32605556 PMCID: PMC7325025 DOI: 10.1186/s12893-020-00808-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 06/23/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Congenital left ventricular diverticulum is a rare cardiac malformation usually requiring total resection. CASE PRESENTATION This report describes an infant presenting with a large apical diverticulum with a wide ventricle connection. Given the vicinity of the left anterior descending coronary artery to the diverticulum and its wide ventricular connection, partial resection was undertaken. The patient remained asymptomatic with good heart function 8 months after surgery. The last follow-up echocardiography did not demonstrate any significant left ventricular outpouching. CONCLUSIONS We advocate early treatment of left ventricular diverticulum in children given the risk of spontaneous rupture of diverticulum, sudden death, and other serious complications if left untreated. For small patients with a wide connection of diverticulum to ventricle, partial resection is a safe option with favorable short-term outcomes.
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Affiliation(s)
- Yibing Fang
- Department of Cardiovascular Surgery, Sichuan University West China Hospital, #37 Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Qi An
- Department of Cardiovascular Surgery, Sichuan University West China Hospital, #37 Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Tianping Yu
- Department of Pathology, Sichuan University West China Hospital, Chengdu, China
| | - Shuhua Luo
- Department of Cardiovascular Surgery, Sichuan University West China Hospital, #37 Guoxue Xiang, Chengdu, 610041, Sichuan, China.
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14
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Lapeña-Reguero M, Fábregas-Casal R, Fernández-Couto M, Barge-Caballero G. Congenital left ventricular outpouching and patent foramen ovale: a potentially emboligenic combination. NEUROLOGÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.nrleng.2018.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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15
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Lapeña-Reguero M, Fábregas-Casal R, Fernández-Couto M, Barge-Caballero G. Evaginación ventricular izquierda congénita y foramen oval permeable: una combinación potencialmente embolígena. Neurologia 2020; 35:334-335. [DOI: 10.1016/j.nrl.2018.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 02/01/2018] [Accepted: 02/13/2018] [Indexed: 11/30/2022] Open
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16
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Accessory left ventricular chamber in a cat: multimodality imaging description by cardiac magnetic resonance imaging and echocardiography. J Vet Cardiol 2020; 28:55-61. [PMID: 32339994 DOI: 10.1016/j.jvc.2020.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/11/2020] [Accepted: 02/17/2020] [Indexed: 11/21/2022]
Abstract
A left ventricular accessory chamber is a complex and uncommon phenotype consisting in a subdivision of the left ventricle by a thick-walled muscle bundle or septum into two cavities. Multiple aetiologies such as congenital double-chambered left ventricle and acquired endomyocardial form of restrictive cardiomyopathy have been reported. The endomyocardial form of restrictive cardiomyopathy, owing to its structural heterogeneity, can present a similar phenotype to the congenital abnormality with intraventricular lesions bridging the ventricular septum and left ventricular free wall. Conventional echocardiography is the first-line, accepted, non-invasive imaging modality to investigate underlying cardiac disease but presents limitations for the overall assessment of myocardial tissue. This report describes the use of cardiac magnetic resonance imaging as an additional imaging modality to provide multiplanar morphological, structural, and functional information of the myocardium. In the presented images, hyperintensities on cardiac magnetic resonance imaging within the myocardium along with hyperechoic and heterogeneous myocardial tissue on echocardiography and elevated troponin I were suggestive of a presumptive acquired pathological process such as feline endomyocarditis-left ventricular endomyocardial fibrosis complex, rather than a sole congenital anomaly. Although the diagnosis was not confirmed, this case exemplifies the advantages of using complementary multimodality imaging in a cat presented with a left ventricular accessory chamber.
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17
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Zheng M, Sun L, Liu X, Wang X, He Y. Autopsy and postnatal follow-up of prenatally diagnosed ventricular outpouchings. Prenat Diagn 2020; 40:681-688. [PMID: 31990991 DOI: 10.1002/pd.5646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Prenatal ventricular outpouchings (VOs), which include congenital ventricular aneurysms (CAs) and congenital ventricular diverticula (CD), are very rare. We describe the features and outcomes of prenatal VOs diagnosed over a 4-year period. METHODS Retrospective cohort study of cases of prenatal diagnoses of CAs and CD at our center between June 2014 and January 2018. The prenatal and postnatal echocardiogram data were reviewed, and telephone follow-up was conducted of liveborn cases. RESULTS A total of 25 VOs were identified. Two were lost to follow-up, 15 chose termination of pregnancy, and eight resulted in livebirths. Only two cases underwent autopsy: Histopathology showed that the CA wall was substituted by collagen fibers. At follow-up, none of the eight liveborn babies experienced adverse events, and three VOs near the tricuspid annulus almost disappeared, though one was extremely large. CONCLUSIONS In our center, all liveborn babies with VO had good prognoses. We hypothesize that VOs located near the right ventricular annulus may be caused by prenatally unbalanced pressure, given their decrease in size after birth when the right heart pressure declines.
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Affiliation(s)
- Min Zheng
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease & Echocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lin Sun
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease & Echocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaowei Liu
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease & Echocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xin Wang
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease & Echocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yihua He
- Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease & Echocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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18
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Shuplock JM, Kavanaugh-McHugh A, Parra D. Prenatally Diagnosed Congenital Ventricular Outpouchings: An Institutional Experience and Review of the Literature. Pediatr Cardiol 2020; 41:272-281. [PMID: 31728571 DOI: 10.1007/s00246-019-02252-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 11/05/2019] [Indexed: 10/25/2022]
Abstract
Congenital ventricular outpouchings (CVOs) are rare congenital heart defects with limited data regarding prognosis and outcomes. We aimed to describe the characteristics, outcomes and factors associated with morbidity and mortality of prenatally diagnosed CVOs using our institutional experience and a review of published cases. A total of 86 cases of prenatally diagnosed CVOs were identified, including 3 from our institution and 83 cases identified from a review of the literature. Fetal and postnatal outcomes were analyzed for each case. Pericardial effusions (44%) and ventricular dysfunction (17%) were the most common associated findings. Excluding cases that resulted in pregnancy termination, mortality was 17%, with the majority (11/13) occurring in the prenatal period. Factors associated with mortality included an outpouching located on the left ventricle, a diagnosis of hydrops fetalis, the presence of a pericardial effusion, and an earlier gestational age at diagnosis. Of those that survived to delivery, 57% remained asymptomatic without the need for intervention, and the outpouching regressed or resolved in an additional 15%. Prenatally diagnosed congenital ventricular outpouchings are a dynamic form of congenital heart disease with a high fetal mortality rate. The outcomes associated with the outpouchings appear to be the most variable in the prenatal period and the first year after birth. Serial prenatal and postnatal evaluations should be performed to evaluate for a change in the characteristics of the outpouching.
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Affiliation(s)
- Jacqueline M Shuplock
- Thomas P. Graham Jr. Division of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 2200 Children's Way, Suite 5230, Nashville, TN, 37232, USA.
| | - Ann Kavanaugh-McHugh
- Thomas P. Graham Jr. Division of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 2200 Children's Way, Suite 5230, Nashville, TN, 37232, USA
| | - David Parra
- Thomas P. Graham Jr. Division of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital at Vanderbilt, 2200 Children's Way, Suite 5230, Nashville, TN, 37232, USA
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19
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Multiple congenital ventricular diverticula causing heart failure. Cardiol Young 2019; 29:410-411. [PMID: 30907335 DOI: 10.1017/s104795111800241x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper reports a case of multiple congenital ventricular diverticula, a rare anomaly that is associated with heart failure.
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20
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Metras A, Pernot M, Bonnet G, Labrousse L. Giant Diverticulum of the Right Ventricle. Circ Cardiovasc Imaging 2019; 12:e008608. [PMID: 30700136 DOI: 10.1161/circimaging.118.008608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Alexandre Metras
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, France
| | - Mathieu Pernot
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, France
| | - Guillaume Bonnet
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, France
| | - Louis Labrousse
- Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, France
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21
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Double-chambered left ventricle – a “heart within a heart”. Forensic Sci Med Pathol 2018; 14:545-547. [DOI: 10.1007/s12024-018-9956-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2018] [Indexed: 10/18/2022]
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22
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Cresti A, Cannarile P, Aldi E, Solari M, Sposato B, Franci L, Limbruno U. Multimodality Imaging and Clinical Significance of Congenital Ventricular Outpouchings: Recesses, Diverticula, Aneurysms, Clefts, and Crypts. J Cardiovasc Echogr 2018; 28:9-17. [PMID: 29629254 PMCID: PMC5875147 DOI: 10.4103/jcecho.jcecho_72_17] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The high spatial resolution of cardiac computed tomography (CT) and cardiac magnetic resonance (CMR) permit the diagnosis of congenital ventricular outpouchings (CVOs), including congenital ventricular diverticula (CVD), congenital ventricular aneurysms (CVA), clefts, and crypts. A unique classification has not been established, and these terms are used interchangeably with confounding terminology. Moreover, their significance is not univocal. A research was performed using PubMed on six subjects: (1) congenital left ventricular outpouchings; (2) congenital ventricular diverticulum; (3) congenital ventricular aneurysm; (4) ventricular clefts; (5) ventricular crypts; and (6) ventricular crevices. Usually, CVOs are small with a preserved contraction and in asymptomatic patients, the clinical relevance may be minimal, although electrocardiographic anomalies are often present. CVA and diverticula may carry an embolic risk and cases of arrhythmia and rupture are described. In the presence of clefts, or crypts a cardiomyopathy should be excluded. A simple classification can be proposed: CVD extend beyond the myocardial wall and fibrous type may be termed CVA, acquired forms should be kept distinct. Clefts, or crypts, are small recesses extending for more than 50% of the ventricular wall but not beyond its margin. The presence of fibrosis may be evaluated by CMR. A multicenter prospective registry would be helpful to investigate potential clinical implications and to exclude dubious forms of hypertrophic cardiomyopathy or ventricular noncompaction. In conclusion, CVOs have been described with different terminologies and classifications. Their significance needs to be interpreted in the clinical setting and with the help of a multimodality imaging, particularly of CMR.
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Affiliation(s)
- Alberto Cresti
- Department of Cardiology, Misericordia Hospital, Grosseto, Italy
| | | | - Elena Aldi
- Department of Radiology, University of Siena, Siena, Italy
| | - Marco Solari
- Department of Cardiology, Misericordia Hospital, Grosseto, Italy
| | - Bruno Sposato
- Department of Internal Medicine, Misericordia Hospital, Grosseto, Italy
| | - Luca Franci
- Department of Radiology, Misericordia Hospital, Grosseto, Italy
| | - Ugo Limbruno
- Department of Cardiology, Misericordia Hospital, Grosseto, Italy
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23
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Kang Y, Li Z, He B. An abnormal structure of the left ventricle. Heart 2017; 104:182. [PMID: 29079632 DOI: 10.1136/heartjnl-2017-312068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/23/2017] [Accepted: 09/12/2017] [Indexed: 12/26/2022] Open
Abstract
CLINICAL INTRODUCTION: A 36-year-old man was referred for evaluation of an abnormal left ventricular (LV) structure found incidentally on transthoracic echocardiography (TTE) (figure 1). He had no symptoms except for mild palpitations. There was no significant medical history. Physical examination was unremarkable. ECG showed regular sinus rhythm with ST changes in lead II, III, avF and V6 (see online supplementary file 1). Cardiac magnetic resonance (CMR) (figure 1C) was performed. Treadmill exercise test did not demonstrate any electrocardiographic ischaemic changes. No arrhythmias were noted on Holter monitor. Which of the following is most likely the diagnosis?DC1SP110.1136/heartjnl-2017-312068.supp1Supplementary file 1 heartjnl;104/2/182/F1F1F1Figure 1Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR). (A) Parasternal left ventricular longitudinal axis view of TTE; (B) colour Doppler of parasternal left ventricular longitudinal axis view of TTE; (C) left ventricular longitudinal axis view of CMR. QUESTIONS A: Lateral and inferolateral myocardial infarctionB: Congenital absence of pericardiumC: PseudoaneurysmD: Congenital left ventricular outpouching.
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Affiliation(s)
- Yu Kang
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zheng Li
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ben He
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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24
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Srettabunjong S. Left Ventricular Aneurysm: Sudden Unexpected Deaths in a 29-Year-Old Man. J Forensic Sci 2017; 63:942-944. [PMID: 28766718 DOI: 10.1111/1556-4029.13605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/27/2017] [Accepted: 07/05/2017] [Indexed: 11/30/2022]
Abstract
Left ventricular aneurysm (LVA) is an abnormal dilated heart structure, either congenital or acquired. LVA is a rare cardiac condition with no symptoms in most cases, thus occasionally diagnosed during investigations of other diseases. Its association with certain cardiac complications and sudden cardiac deaths has been reported. However, its role as a cause of sudden unexpected death is rare. The author reported a sudden cardiac death in a 29-year-old man with LVA. Without a significant coronary artery disease and known etiologies of LVA, such an abnormal heart structure in the present case was considered congenital LVA. As no other possible mechanisms of death could be identified other than LVA with its associated pathologic lesions, mural thrombi, and dilated cardiomegaly, his death was attributable to fatal cardiac arrhythmia (most commonly ventricular tachycardia) secondary to LVA.
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Affiliation(s)
- Supawon Srettabunjong
- Department of Forensic Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
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25
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Hung WL, Chen SJ, Lin SM, Chen MR. A Congenital Left Ventricular Aneurysm: A Cause of Premature Ventricular Complex in a Premature Infant. Pediatr Neonatol 2017; 58:196-197. [PMID: 28283315 DOI: 10.1016/j.pedneo.2016.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/24/2016] [Accepted: 06/27/2016] [Indexed: 11/17/2022] Open
Affiliation(s)
- Wei-Li Hung
- Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan
| | | | - Shan-Miao Lin
- Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ming-Ren Chen
- Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
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26
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Severe Aortic Stenosis With a Large Infra-aortic Annular Aneurysm of the Ventricular Septum Treated With CoreValve. Can J Cardiol 2017; 33:688.e13-688.e15. [PMID: 28318899 DOI: 10.1016/j.cjca.2017.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 01/10/2017] [Accepted: 01/18/2017] [Indexed: 11/20/2022] Open
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27
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"Aberrant" Papillary Muscle in a High-Endurance Athlete? The Importance of Advanced Cardiac Imaging. Can J Cardiol 2016; 33:293.e7-293.e8. [PMID: 27789108 DOI: 10.1016/j.cjca.2016.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 08/05/2016] [Accepted: 08/07/2016] [Indexed: 11/22/2022] Open
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28
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Dipak NK, Venkatesh S, Prabhu S, Rao S. Evolution of ventricular outpouching through the fetal and postnatal periods: Unabating dilemma of serial observation or surgical correction. J Saudi Heart Assoc 2016; 29:203-210. [PMID: 28652674 PMCID: PMC5475357 DOI: 10.1016/j.jsha.2016.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 10/10/2016] [Accepted: 10/13/2016] [Indexed: 02/01/2023] Open
Abstract
Ventricular outpouching is a rare finding in prenatal sonography and the main differential diagnoses are diverticulum, aneurysm, and pseudoaneurysm in addition to congenital cysts and clefts. The various modes of fetal presentation of congenital ventricular outpouching include an abnormal four-chamber view on fetal two-dimensional echocardiogram, fetal arrhythmia, fetal hydrops, and pericardial effusion. Left ventricular aneurysm (LVA)/nonapical diverticula are usually isolated defects. Apical diverticula are always associated with midline thoracoabdominal defects (epigastric pulsating diverticulum or large omphalocele) and other structural malformations of the heart. Most patients with LVA/congenital ventricular diverticulum remain clinically asymptomatic but they can potentially give rise to complications such as ventricular tachyarrhythmias, systemic embolism, sudden death, spontaneous rupture, and severe valvular regurgitation. The treatment of asymptomatic LVA and isolated congenital ventricular diverticulum is still undefined. In this review, our aim is to outline a systematic approach to a fetus detected with ventricular outpouching. Starting with prevalence and its types, issues in fetal management, natural course and evolution postbirth, and finally the perpetual dilemma of serial observation or surgical correction is discussed.
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Affiliation(s)
- Niraj Kumar Dipak
- Department of Neonatology, B J Wadia Hospital for Children, Nowrosjee Wadia Maternity Hospital, Acharya Donde Marg, Parel, Mumbai, Maharashtra, aIndia
| | - Sumitra Venkatesh
- Department of Pediatric Cardiology, B J Wadia Hospital for Children, Nowrosjee Wadia Maternity Hospital, Acharya Donde Marg, Parel, Mumbai, Maharashtra, bIndia
| | - Shakuntala Prabhu
- Department of Pediatric Cardiology, B J Wadia Hospital for Children, Nowrosjee Wadia Maternity Hospital, Acharya Donde Marg, Parel, Mumbai, Maharashtra, bIndia
| | - Sudha Rao
- Department of Neonatology, B J Wadia Hospital for Children, Nowrosjee Wadia Maternity Hospital, Acharya Donde Marg, Parel, Mumbai, Maharashtra, aIndia
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29
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Płużańska J, Więcek J, Krekora M, Kiełbasicz-Binikowska J, Talar T, Słodki M, Respondek-Liberska M. Emergency Cesarean Section in Case of Aneurysm of the Muscular Intraventricular Septum with Neonatal Follow-up - A Case Report and Review of the Literature. PRENATAL CARDIOLOGY 2016. [DOI: 10.1515/pcard-2016-0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
We present the case of aneurysm of the muscular intraventricular septum with accompanying cardiomegaly and abnormal venous flow patterns requiring emergency cesarean section and specialized neonatal treatment. At the age of 8 months our patient has no clinical symptoms with a 6 mm scar in intraventricular muscular septum..
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Affiliation(s)
- Joanna Płużańska
- 1. Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute
| | - Jacek Więcek
- 2. Department of Cardiology, Polish Mother’s Memorial Research Institute
| | - Michał Krekora
- 3. Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital Research Institute
| | - Jolanta Kiełbasicz-Binikowska
- 1. Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute
- 2. Department of Cardiology, Polish Mother’s Memorial Research Institute
| | - Tomasz Talar
- 4. Department of Neonatology, Polish Mother’s Memorial Hospital Research Institute
| | - Maciej Słodki
- 1. Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute
- 5. Institute of Health Sciences, The State School of Higher Professional Education in Płock, Poland
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30
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Capasso R, Panelo M, Fiorelli A, Carbone I, Galea N. Diverticulum, or not Diverticulum, That Is the Question! Discussing About a Case of Left Ventricular Outpouching Associated With Bicuspid Aortic Valve Assessed by Cardiac Magnetic Resonance. J Cardiovasc Thorac Res 2015; 7:72-4. [PMID: 26191396 PMCID: PMC4492182 DOI: 10.15171/jcvtr.2015.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 05/02/2015] [Indexed: 12/26/2022] Open
Abstract
Congenital left ventricular outpouchings (LVOs) are infrequent myocardial malformations, comprising various overlapping abnormalities, whose characterization is often intricate in clinical practice using traditional non-invasive techniques. We describe a rare case of LVO associated with bicuspid aortic valve incidentally found in an asymptomatic adult patient. The LVO was located at basal level of the chamber, crescent-shaped with its largest diameter in short-axis view and presented a thin hypo-contractile wall without hyperintense areas on late gadolinium enhanced (LGE) images. This description corresponds to an overlap between usual definition of aneurism, fibrous and muscular diverticulum. The LVO was evaluated according with a classification recently proposed by Malakan Rad. In this case ventricular geometry was not respected, wall thickness was reduced and wall motion compromised therefore corresponding to a small IIc-type, which is considered having the poorest prognosis. Furthermore, the association with bicuspid aortic valve is very unusual. The patient refused surgery and preferred follow-up.
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Affiliation(s)
- Raffaella Capasso
- Department of Internal Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
| | - Maria Panelo
- Department of Cardiology, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain
| | - Andrea Fiorelli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Iacopo Carbone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Nicola Galea
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
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