Prenatal diagnosis of left ventricular aneurysm

Balakumar, K

doi:10.4103/0971-3026.45353

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…Cardiac ventricular aneurysms affect 1 in 200,000 live births [ 1 ]. The first reported case diagnosed prenatally was published in 1990, however, to the best of our knowledge, no reported cases of a left ventricular pseudoaneurym and in utero rupture exist to guide optimal management [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

In utero fetal left ventricular rupture and pseudoaneurysm formation: a case report

Heland

Hope

Edwards

et al. 2021

BMC Pregnancy Childbirth

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Background Cardiac ventricular aneurysms affect 1 in 200,000 live births. To the best of our knowledge, no reported cases of a left ventricular pseudoaneurym and in utero rupture exist to guide optimal management. Case presentation We present a case of fetal left ventricular rupture with a large pericardial effusion, cardiac tamponade and subsequent pseudoaneurysm formation with concerns for a poor prognosis. Interventional drainage of the pericardial effusion led to resolution of tamponade and significant improvement in fetal condition. A multidisciplinary team was utilised to plan birth to minimise risk of pseudoaneurysmal rupture and a catastrophic bleed at birth. Conclusion For similar cases we recommend consideration of birth by caesarean section, delayed cord clamping and a prostaglandin E1 infusion, to reduce the systemic pressures on the left ventricle during transition from fetal to neonatal circulations, until definitive surgical repair. In this case, this resulted in a successful outcome.

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Section: Introductionmentioning

confidence: 99%

In utero fetal left ventricular rupture and pseudoaneurysm formation: a case report

Heland

Hope

Edwards

et al. 2021

BMC Pregnancy Childbirth

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Electrophysiologic features of fetal ventricular aneurysms and diverticula

et al. 2014

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Objective Congenital ventricular wall defects are very rare and include congenital ventricular aneurysms (CVAs) and diverticula (CVDs). Method We report a series of five fetuses: three with CVAs and two with CVDs referred due to fetal arrhythmia. In addition to routine fetal echocardiography, fetal magnetocardiography (fMCG) was used. The literature in CVA and CVD is reviewed. Results Incessant premature ventricular contractions (PVC), mainly bigeminy and trigeminy were found in three fetuses with CVAs and in one with CVD, who also had ventricular couplets. The other fetus with CVD, referred because of PVCs, had only sinus tachycardia. ST elevation was noted in two. Fetal movement had a variable impact on PVC’s. Postnatal evaluation demonstrated two persistent left ventricular aneurysms and one persistent right CVD; one CVD resolved at 35 weeks gestation. Two neonates had incessant PVCs. Both arrhythmias resolved spontaneously while being treated with propranolol. Conclusion FMCG is complementary to echocardiographic imaging. In fetuses with left ventricular wall defects, additional electrophysiological diagnosis can be made by fMCG, including the complexity of ventricular ectopy, arrhythmic response to fetal movement, presence of ST-T wave abnormalities, and atrial amplitude increases. Prenatal risk factor assessment using fMCG can additionally support post-natal treatment and follow-up.

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