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A Heart Elsewhere: The Unusual Diagnosis of a Congenital Ventricular Diverticulum in the Abdomen.

ABSTRACT: Congenital left ventricular (LV) diverticulum is a rare condition characterized by the presence of a contractile appendix originating usually from the cardiac apex, but with high variability in location, dimension, and clinical presentation. We describe the diagnostic process and clinical management of an isolated apical diverticulum discovered during fetal life. (Level of Difficulty: Advanced.).

SUBMITTER: Avesani M

PROVIDER: S-EPMC8446024 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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A Heart Elsewhere: The Unusual Diagnosis of a Congenital Ventricular Diverticulum in the Abdomen.

Avesani Martina M Martin Amandine A Thomas-Chabaneix Julie J Thambo Jean-Benoit JB Iriart Xavier X

JACC. Case reports 20210915 12

Congenital left ventricular (LV) diverticulum is a rare condition characterized by the presence of a contractile appendix originating usually from the cardiac apex, but with high variability in location, dimension, and clinical presentation. We describe the diagnostic process and clinical management of an isolated apical diverticulum discovered during fetal life. (<b>Level of Difficulty: Advanced.</b>). ...[more]

PMID: 34557691

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Project description:BackgroundCongenital left ventricular diverticulum (LVD) is a rare cardiac malformation. Its prevalence rate is less than 0.1% of the congenital heart diseases requiring surgery. Some scholars suggest that all LVD should be actively removed to prevent possible risks, including diverticulum rupture, arterial embolism, and malignant arrhythmia. However, others believe that asymptomatic LVD can be followed up without immediate surgery. We reviewed and reported the diagnosis, clinical features, and surgical treatment of four cases of congenital LVD to provide clinical experience and a reference for the treatment of such patients.MethodsFour patients (aged 3-32 years old) were diagnosed with congenital LVD and received surgical treatment at the Department of Cardiovascular Surgery of PLA General Hospital, Beijing, China from September 2009 to July 2019. All four patients had complete long-term postoperative follow-up data, including echocardiogram, enhanced cardiac computed tomography (CT), and electrocardiogram to monitor changes in left ventricular structure, heart function, and heart rhythm.ResultsIn the first case, the fibrodiverticulum under the aortic valve squeezed the right ventricular outflow tract and the right main coronary artery; the morphology of the right ventricle and coronary artery returned to normal after surgery. The second patient was complicated with a huge lipoma in the apex of the left ventricle and underwent lipoma resection during LVD resection surgery. The third and fourth cases had muscular diverticula in the left ventricular apexes and received LVD removal surgery. All four patients recovered well after surgery and their left ventricular morphology and cardiac function were normal without adverse complications, such as atrial fibrillation, ventricular arrhythmia, and cerebrovascular accident.ConclusionsAlthough the morphology and character of congenital LVD were different in each case, the use of effective diagnostic and follow-up tools, including echocardiogram, enhanced CT, and magnetic resonance imaging (MRI), allowed for successful surgical treatment of the left ventricular diverticula and symptoms or other malformations. We propose that congenital LVD should be actively treated with surgery, especially considering effectiveness and low risk associated with this therapeutic option.

Dataset Information

A Heart Elsewhere: The Unusual Diagnosis of a Congenital Ventricular Diverticulum in the Abdomen.

Publications

A Heart Elsewhere: The Unusual Diagnosis of a Congenital Ventricular Diverticulum in the Abdomen.

Similar Datasets

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