Congenital Left Ventricular Outpouchings: A Systematic Review of 839 Cases and Introduction of a Novel Classification after Two Centuries

Abstract

The cornerstone of this classification is elliptical LV geometry. Large-type IIc LVO have dismal prognosis, if left untreated. LVO type I and small LVO type IIa have the best prognosis.

A Congenital Left Ventricular Aneurysm: A Cause of Premature Ventricular Complex in a Premature Infant

“…Three-dimensional contrast-enhanced computed tomographic and virtual cardioscopic images 1 and animations showed a thin-walled outpouching with a smooth inner surface without trabeculation ( Figures 3A and 3B, Movie S2). The above images are compatible with a congenital left ventricular aneurysm of the large type IIc left ventricular outpouching (LVO), according to the new classification proposed by Malakan et al 2 We started digoxin for congestive heart failure and low-dose aspirin to prevent thromboembolism. 3 Although he was discharged at the postmenstrual age of 35þ1 weeks after the electrocardiogram resumed as normal, a future elective aneurysmectomy will still be arranged for his large type IIc LVO, which is at a high risk of spontaneous rupture.…”

“…3 Although he was discharged at the postmenstrual age of 35þ1 weeks after the electrocardiogram resumed as normal, a future elective aneurysmectomy will still be arranged for his large type IIc LVO, which is at a high risk of spontaneous rupture. 2 Supplementary data related to this article can be found at http://dx.doi.org/10.1016/j.pedneo.2016.06.003.PVCs in premature infants are not unusual. However, a congenital left ventricular aneurysm is a rare disease entity occurring in 0.5 per 10,000 live births.…”

“…Complications including thromboembolism, a rupture of the aneurysm, and sudden death have been reported. Malakan et al 2 proposed a new classification system for LVOs to distinguish high-risk groups with a poor prognosis. 2 A surgical aneurysmectomy for a high-risk group is suggested.…”

“…Malakan et al 2 proposed a new classification system for LVOs to distinguish high-risk groups with a poor prognosis. 2 A surgical aneurysmectomy for a high-risk group is suggested. Figure 1 A complete 12-lead electrocardiogram of this premature infant showed premature ventricular complex bigeminy in the right-bundle branch block with a superior axis pattern, raising a concern of left ventricle apical lesions.…”

An abnormal structure of the left ventricle

“…Several terms have been used in the literature including LV aneurysm, LV diverticulum, LV accessory chamber and double-chambered LV 1. Malakan et al 2 introduced a classification for congenital LVOs based on LV geometry, small outpouching size, and normal thickness and wall motion, all of which have been associated with better outcomes. Congenital non-apical LVO is more commonly found as an isolated anomaly while apical LVO is commonly associated with intracardiac or extracardiac malformation 3.…”