Congenital diverticulum of the left ventricle. Report of two unusual cases.

Mardini, Mohammed K.

doi:10.1136/hrt.51.3.321

Cited by 46 publications

(26 citation statements)

References 15 publications

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“…The etiology of cardiac diverticula and aneurysms in fetal life is poorly understood. They may occur as a result of focal weakening of the ventricular wall due to an interruption during embryogenesis, infection6–8 or from localized ischemia of the ventricular wall from diseased coronary arteries such as stenosis, hypoplasia or intimal proliferation4, 6. In the two cases reported here, the pericardial effusion and diverticulum were detected in the first trimester, suggesting that these defects occurred early in pregnancy or even during embryogenesis.…”

Section: Discussionmentioning

confidence: 68%

Cardiac diverticulum with pericardial effusion: report of two new cases treated by in‐utero pericardiocentesis and a review of the literature

McAuliffe

Hornberger

Johnson

et al. 2005

Ultrasound in Obstet & Gyne

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Congenital CASE REPORTS Case 1A 35-year-old healthy multiparous woman was referred at 16 weeks' gestation for assessment of fetal pericardial effusion. An ultrasound scan at 7 weeks demonstrated that gestation was consistent with the patient's dates. A further ultrasound scan at 13 weeks revealed a nuchal translucency (NT) of 4.2 mm and a pericardial effusion. This prompted an amniocentesis, which revealed a normal male karyotype (46,XY). At 16 weeks' gestation a large pericardial effusion was noted with a right-sided cardiac diverticulum measuring 4 × 6 mm. Color Doppler imaging demonstrated blood flow within the diverticulum (Figure 1). Both lungs were compressed into a posterior position in the fetal thorax. Nuchal fold measurement was normal at 2.5 mm. There was no evidence of other structural fetal anomalies, hydrops, or structural or functional cardiac defects.The patient was counseled that the presence of a significant pericardial effusion over the previous 3 weeks could result in pulmonary hypoplasia and progressive hydrops. She opted for pericardiocentesis, which was performed at 16 weeks' gestation, and 3 mL of bloodstained serous fluid was aspirated. Immediately the lungs re-expanded. Pericardial fluid, amniotic fluid and maternal serum were referred for viral studies which were subsequently negative for TORCH, parvovirus B19, echovirus and adenovirus. Cytology of the pericardial fluid identified lymphocytes and mesothelial cells. The protein content of the pericardial fluid was 18 g/L, consistent with a transudate. The pericardial effusion did not return following pericardiocentesis. The right ventricular diverticulum was visible on ultrasound at 19 and at 33 weeks, measuring 4 × 7 mm at the apex of the right ventricle (Figure 2). However, at 37 weeks' gestation the cardiac diverticulum was no longer visible.At 38 weeks' gestation the patient delivered a live male infant in good condition weighing 3040 g. A neonatal echocardiogram revealed branch pulmonary arteries of 3.6 mm in diameter, which is low normal for age. There was no evidence of either a right ventricular diverticulum

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Section: Discussionmentioning

confidence: 68%

Cardiac diverticulum with pericardial effusion: report of two new cases treated by in‐utero pericardiocentesis and a review of the literature

McAuliffe

Hornberger

Johnson

et al. 2005

Ultrasound in Obstet & Gyne

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show abstract

“…13,22 However, patients with a small left ventricular diverticulum may have normal studies. In our case, echocardiography initially demonstrated an abnormal structure arising from the left ventricle near the mitral valve ring compressing the left atrium which was clearly defined on the CT scan.…”

Section: Discussionmentioning

confidence: 98%

Congenital Left Ventricular Diverticulum

Shauq

Agarwal

Crawley

2006

Heart, Lung and Circulation

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“…They may occur as result of focal weakening of the ventricular wall due to an interruption during embryogenesis, infection [8][9][10], or from localized ischemia of the ventricular wall from diseased coronary arteries such as stenosis, hypoplasia or intimal proliferation [8][9][10][11]. Most cardiac diverticula have been reported from mid-gestation [4,12].…”

Section: Discussionmentioning

confidence: 99%

Fetal Congenital Cardiac Diverticulum with Pericardial Effusion: A Case Treated by Urgent Thoracic Surgery

Daou¹,

Hanna²,

Sayah³

et al. 2015

Intensive & Crit Care

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A healthy 26-year-old woman, gravida 2 para 2 aborta 0, with a good course of pregnancy. An ultrasound done at 35 weeks of gestation was normal. In a routine third trimester ultrasound, done at 36 weeks of gestation, the fetus presented with a minimal pericardial effusion.The second day, the ultrasound was repeated by another obstetrician, with the same minimal cardiac effusion, a good heart rate and normal systolic function.On the same afternoon, the mother was referred to a pediatric cardiologist for assessment. An ultrasound done showed that the pericardial effusion had become enormous, causing cardiac tamponade and severe bradycardia (30 beats/min), without architectural anomalies (Figure 1).During the exam, the cardiologist observed that the effusion, previously hypo echoic, was progressively becoming hyper echoic, before turning into a complete hyper echoic effusion 10 minutes after (Figure 2).These results proved that the fetus was experiencing an active pericardial bleeding at the time of the ultrasound.Considering the life-threatening nature of the situation, the mother was sent to Hotel Dieu de France for an urgent C-section.An obstetrician, a neonatal pediatrician and a pediatric cardiac surgeon along with the pediatric cardiologist stood ready to handle the case.A C-section was performed and the baby girl was born with an Apgar score of 7 and 9, at 1 and 5 minutes of birth respectively. A cardiac ultrasound done at birth showed the same hyper echoic structure, surrounded by a new pericardial effusion.In view of the case, the C-section was exceptionally performed in the cardio-vascular operating theater so that the newborn can be directly transferred to the adjacent operating room.At the start of surgery, the newborn was hemodynamically unstable. As soon as the pericardial effusion was drained (30 The fetus presented with a large cardiac effusion one day before his birth, and an active pericardial bleeding with tamponade and severe bradycardia right before the urgent C-section. Drainage of the effusion done right after the delivery, with good neonatal outcome.

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Congenital diverticulum of the left ventricle. Report of two unusual cases.

Cited by 46 publications

References 15 publications

Cardiac diverticulum with pericardial effusion: report of two new cases treated by in‐utero pericardiocentesis and a review of the literature

Cardiac diverticulum with pericardial effusion: report of two new cases treated by in‐utero pericardiocentesis and a review of the literature

Congenital Left Ventricular Diverticulum

Fetal Congenital Cardiac Diverticulum with Pericardial Effusion: A Case Treated by Urgent Thoracic Surgery

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