Characteristics and outcome of congenital left ventricular aneurysm and diverticulum: Analysis of 809 cases published since 1816

Ohlow, Marc‐Alexander; Korn, Hubertus von; Lauer, Bernward

doi:10.1016/j.ijcard.2015.03.050

Cited by 92 publications

(199 citation statements)

References 197 publications

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“…Symptoms at the time of diagnosis and presence of several distinct electrocardiogram findings (T‐wave repolarization disturbances, atrial fibrillation, right bundle branch block, prolonged PR interval) are predictive for an increased incidence of adverse events during follow‐up. While electrophysiological study (EPS) was only performed in a minority of cases, 10 patients with preoperatively inducible VT were free from arrhythmia at the second EPS after surgical correction 2 . However, in our first patient presenting initially with sudden death by ventricular arrhythmia, the preserved inducibility of VT during electrophysiological testing indicated imperatively the need for ICD implantation, despite complete resection of the diverticulum.…”

Section: Discussionmentioning

confidence: 82%

“…Associated vascular and extracardiac anomalies have also been reported. Multiple LVD can be seen in one patient 2 …”

Section: Discussionmentioning

confidence: 97%

“…Although LVD is often found coincidentally, due to their asymptomatic character, one‐fifth of them are diagnosed by rhythm disturbances as first clinical presentation. Other symptoms are congestive heart failure (6% in diverticula compared with 21% in aneurysms), embolic events from thrombotic material inside the aneurysmal sac (3%‐5%), rupture (4%) or eventually significant valvular disease for those diverticula and aneurysms interfering with valve function 2 …”

Section: Discussionmentioning

confidence: 99%

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Congenital left ventricular diverticulum: A rare cause of cardiac arrhythmia

et al. 2020

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Congenital left ventricular diverticula are rare cardiac malformations that usually remain asymptomatic. However, life‐threatening complications as ventricular arrhythmias, systemic embolism, spontaneous rupture and development of valvular regurgitation, are described. Diagnosis is based on excluding coronary artery disease, traumatic or inflammatory causes, and other underlying cardiomyopathies. Treatment is directed towards the potential complications, yielding mainly therapy of ventricular arrhythmia. Surgical resection is required for larger‐sized congenital aneurysms with adverse hemodynamic effects. We present two cases of a left ventricular diverticulum causing cardiac arrhythmia which led to further surgical treatment.

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Section: Discussionmentioning

confidence: 82%

“…Associated vascular and extracardiac anomalies have also been reported. Multiple LVD can be seen in one patient 2 …”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Congenital left ventricular diverticulum: A rare cause of cardiac arrhythmia

et al. 2020

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“…The development of an LVD can be explained by an interruption during the development of the embryonic ventricle in this period. 2 LVD has a narrower inlet, and layers of myocardium and contractility synchronized to cardiac cycle, which is different to LV aneurysm (LVA). Although we did not obtain any tissue samples, this lesion was very similar to an LVD because the lesion had a narrow neck and synchronized myocardial contraction.…”

mentioning

confidence: 99%

Coarctation of the aorta and left ventricular diverticulum in Kabuki syndrome

Kim

Lee

et al. 2019

Pediatrics International

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Key words coarctation of the aorta, diverticulum, Kabuki syndrome, left ventricle.The present patient was an 11-month-old male infant, who had undergone surgical repair of coarctation of the aorta (CoA) and atrial septal defect (ASD) at 7 days of age. He was clinically diagnosed with Kabuki syndrome (KS) on the presence of characteristic facial features, clinodactyly of the fifth finger, persistent finger fetal pads, postnatal growth retardation, and developmental delay. At the time of initial computed tomography (CT), small crypt (diameter, 2.6 mm) was noted on the lateral side of the left ventricle (LV), and we decided to follow up this lesion. When he visited the outpatient clinic for a periodic exam at 7 months old, we noted an LV diverticulum (LVD) where the small crypt was located on 2-D echocardiography. On subcostal view, an accessory tongue-shaped chamber with a narrow neck (diameter of the body, 5 mm) was seen in the LV apex. The contraction of the diverticulum was synchronous with that of the LV, and color flow mapping indicated rapid diastolic filling inside the diverticulum. Because the patient was asymptomatic, we decided to do medical follow up frequently. On 2-D echocardiography at 9 months of age ( Fig. 1a), the LVD had increased in size to approximately 9.6 mm (diameter of the body) compared with the previous imaging. On cardiac catheterization, we gained more precise imaging of the location, size and morphology of the LVD (Fig. 1b). Although the patient had no symptoms, we were concerned about life-threatening complications of LVD such as cardiac rupture because the LVD was increasing rapidly. Finally, surgery was decided upon, to avoid life-threatening complications. At the age of 11 months, he underwent redo median sternotomy with preparation for cannulation. The diverticulum was identified arising from the LV near the left anterior descending artery. Tenting sutures were placed at the diverticular sac, and the diverticular sac was then incised (Fig. 1c). The diverticular stump was identified with coronary probe, and obliterated with purse-string sutures. The diverticular sac was closed with bovine pericardium, pledget-buttressed horizontal mattress sutures and

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“…The mechanism of the in situ relapse of the LVD in our case is unknown, though the fracture of the suture should be the most supposed reason [1]. We prefer a new minimally invasive technique, transapical transcatheter LVD device closure, rather than conventional re-open heart surgery in this case for several reasons.…”

mentioning

confidence: 98%

Transapical transcatheter device closure of relapse left ventricular diverticulum: a novel minimally invasive technique for reoperation

Zhang

Gao

Yang

et al. 2016

J Cardiothorac Surg

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We describe a novel minimally invasive technique, transapical transcatheter device closure of relapse left ventricular diverticulum (LVD) under transesophageal echocardiography (TEE) guidance. The patient previously underwent LVD primary repair and mitral valvular replacement. The anatomical characteristics of the relapse LVD and its adjacent structures are detailedly delineated by echocardiography. The relapse LVD is then managed by transapical transcatheter device closure under TEE guidance. This novel minimally invasive technique is not only limited in relapse LVD, but also could be extensively applied in other cardiac reoperation, such as perivalvular leak closure after valvular replacement.

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Characteristics and outcome of congenital left ventricular aneurysm and diverticulum: Analysis of 809 cases published since 1816

Cited by 92 publications

References 197 publications

Congenital left ventricular diverticulum: A rare cause of cardiac arrhythmia

Congenital left ventricular diverticulum: A rare cause of cardiac arrhythmia

Coarctation of the aorta and left ventricular diverticulum in Kabuki syndrome

Transapical transcatheter device closure of relapse left ventricular diverticulum: a novel minimally invasive technique for reoperation

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