Double-chambered left ventricle in an adult: diagnosis by CMRI

Nacif, Marcelo Souto; Mello, Raquel Rodrigues Costa; Lacerda, Orly; Sibley, Christophe T; Machado, Renato Assis; Marchiori, Edson

doi:10.1590/s1807-59322010001200028

Cited by 26 publications

(36 citation statements)

References 10 publications

(21 reference statements)

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“…Some cases have been reported as related to cardiomyopathy and some ischemic, viral or genetic factors, but the underlying evidence for those etiologies is weak . Because of the rarity of DCLV, few data exist on about its treatment and clinical outcomes . Surgical intervention is indicated only if DCLV is complicated with other congenital anomalies .…”

Section: Discussionmentioning

confidence: 99%

Double‐chambered left ventricle diagnosis by 2D and 3D echocardiography: From fetus to birth

et al. 2018

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A 26-year-old pregnant woman, 24 weeks gestation, underwent fetal echocardiography because of abnormal fetal heart on routine obstetric ultrasound screening. The maternal and pregnancy medical histories were normal. 2D and 3D Fetal echocardiography showed the left ventricle (LV) divided into two chambers by an abnormal transverse muscular tissue at the level of the papillary muscle. The overall LV systolic function was normal. The communication between the two chambers was 2.1 mm in diameter and showed clear evidence for bidirection flow on color Doppler with a diastolic velocity of 61 cm/s and systolic velocity of 58 cm/s ( Figure 1A,B). After delivery, a transthoracic echocardiogram showed the same findings reported during fetal life. The baby was asymptomatic and the ECG was normal. One and a half year after birth, LV systolic function remained normal (EF 65%) as was diastolic function (E wave velocity 120 cm/s, A wave velocity 60 cm/s and E/A = 2). LV wall motion also was normal and the communication between the LV main chamber and accessary chamber became 5 mm. The bidirection flow acrossing the connection between the two chambers was slightly faster with diastolic velocity 157 cm/s and systolic velocity 102 cm/s ( Figure 1C,D). | D ISCUSS I ONDouble-chambered left ventricle is a very rare congenital cardiac anomaly, the two chambers of DCLV are in parallel with superior/ inferior chambers or left/right chambers. 1 This anomaly can exist in isolation or in association with other congenital anomalies. The pathogenesis of DCLV is unknown. 2,3 Some cases have been reported as related to cardiomyopathy and some ischemic, viral or genetic factors, but the underlying evidence for those etiologies is weak. 4-6 Because of the rarity of DCLV, few data exist on about its treatment and clinical outcomes. 7-10 Surgical intervention is indicated only if DCLV is complicated with other congenital anomalies. 11 DCLV should be distinguished from ventricular aneurysm and ventricular diverticulum, the former is usually secondary to myocardial infarction and does not contain all layers of myocardium and may show dyskinetic segments. The latter is congenital Double-chambered left ventricle (DCLV) is a rare cardiac anomaly and is characterized by the division of the left ventricle by abnormal muscle and/or fiber bundles into two chambers. We hereby report a fetus which was diagnosed with DCLV in utero by 2D and 3D Fetal echocardiography and the findings were confirmed after birth. K E Y W O R D Sdouble-chambered left ventricle, echocardiography, fetus

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Section: Discussionmentioning

confidence: 99%

Double‐chambered left ventricle diagnosis by 2D and 3D echocardiography: From fetus to birth

et al. 2018

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“…Magnetic resonance imaging will characterize the condition better because of its higher spatial resolution and the ability for tissue characterization, especially with the differentiation between fibrosis and normal myocardium. [4] Detection of an accessory chamber in communication with the LV cavity needs special consideration, because an LV aneurysm or diverticulum can sometimes mimic a double-chambered LV. Therefore, a precise evaluation of their wall motion during systole and diastole as well as the width of their communication with the main LV cavity would help to differentiate between these entities [5].…”

Section: Discussionmentioning

confidence: 99%

“…Accessory cavities sequestrated by aberrant muscular ridges are not well recognized. Surgically, they may be resolved by a resection of the aberrant tissue [4]. Indications for surgery must be made for each individual case as there have only been few reports on this pathology.…”

Section: Discussionmentioning

confidence: 99%

Double-chambered left ventricle in a young previously healthy man presenting for a routine echocardiographic study (RCD code: IV-1B.2o)

Mizia‐Stec

Bochenek

Mizia³

2013

Journal of Rare Cardiovascular Diseases

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A double-chambered left ventricle (DCLV) constitutes a rare congenital malformation. It is usually diagnosed at a neonatal or pediatric age, and often exhibits mixed criteria for diverticulae and aneurysms. This anomaly is characterized by the subdivision of the left ventricle into two chambers by an abnormal septum or muscle band. In this article, we present the case of 30-year-old asymptomatic patient, in whom DCLV was diagnosed by routine echocardiographic study. JRCD 2013; 1 (4): 155-157

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“…[2][3][4][5] Transthoracic echocardiography in short-axis inverted views and apical four-chamber views show a transverse muscle band traversing the LV dividing the LV into two halves, producing a typical "figure-of-eight" appearance, indicating a double-chambered. [8] However, cardiac magnetic resonance imaging allows an improved delineation of this condition, thanks to its higher spatial resolution and the ability for tissue characterization, particularly regarding the differentiation between fibrosis and normal myocardium, which would not be easily achievable with echocardiography [8] or computed tomography. [3] In the literature, several treatment strategies have been described.…”

Section: Type 1 Type 2 Typementioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] Unlike double-chambered right ventricle (DCRV), division of the left ventricle (LV) is a rare anomaly. [1][2][3][4][5] Previously, the description of the double-chambered left ventricle (DCLV) was given by Gerlis et al [1] and Kay et al [2] Herein, we describe a case of DCRV and DCLV in an 18-year-old female.…”

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confidence: 99%

Combined double-chambered right ventricle with double-chambered left ventricle: a rare anomaly

Gajjar¹

2017

Cardiovasc Surg Int

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ABSTR ACTDouble-chambered right ventricle with double-chambered left ventricle is a very rare congenital anomaly. An 18-year-old female presented with dyspnea, chest pain, and palpitation. Diagnosis was made using transthoracic echocardiography and was confirmed by angiography. Surgical excision of the anomalous muscle bundles in the right ventricular outflow tract along with excision of the fibrous band from the left ventricle was performed. The postoperative course was uneventful and repeated echocardiogram before discharge showed a right ventricular outflow tract gradient of 8 mmHg, no gradient across the left ventricular cavity, and improved biventricular functions. The management strategy is dependent on presence of symptom, associated anomalies and type of pathology.Keywords: Angiography; double-chambered left ventricle; double-chambered ventricle; echocardiography; infundibular stenosis; subaortic stenosis. Double-chambered ventricle is a rare congenital cardiac anomaly, where the ventricular chamber is wholly or partially partitioned usually by abnormal muscular ridges or fibrosis.[1-9] Unlike double-chambered right ventricle (DCRV), division of the left ventricle (LV) is a rare anomaly. [1][2][3][4][5] Previously, the description of the double-chambered left ventricle (DCLV) was given by Gerlis et al. [1] and Kay et al. [2] Herein, we describe a case of DCRV and DCLV in an 18-year-old female. CASE REPORTAn 18-year-old female patient presented with dyspnea, chest pain, and palpitation. The physical examination revealed a Grade 4/6 ejection systolic murmur at the left upper sternal border. Chest X-ray showed a cardiothoracic ratio of 50% with reduced pulmonary blood f low. Electrocardiogram showed right ventricular hypertrophy. Transthoracic echocardiography revealed levocardia and DCRV with a gradient of 70/58 mmHg associated with a ledge of muscle tissue in the LV cavity below the mitral valve (Figure 1a) with 30 mmHg gradient across the constriction with figure of 8 appearance in apical 4 chamber view. No regional wall motion abnormality and improved biventricular functions were observed. Cardiac catheterization revealed a right atrial pressure of 21/0 mmHg with a mean of 10 mmHg, a right ventricular pressure of 157/10 mmHg, a right ventricular outf low tract of 31/10 mmHg, a pulmonary artery of 33/11 mmHg, a pulmonary artery wedge of 17/6 mmHg, a LV apex of 162/11 mmHg, a LV outf low tract of 152/76 mmHg, an aortic pressure of 141/83 mmHg, and a femoral artery pressure of 157/77 mmHg. The gradient between the right ventricular body and the outf low tract was 126 mmHg, while the gradient across the fibrous ridge between the LV apex and outf low was 10 mmHg. Left ventricular angiography showed a ledge of tissue in the mid-LV cavity below the mitral valve (Figure 1b), separating the LV with a hypertrophied distal chamber and thin-walled proximal chamber. Right ventricular angiography revealed the presence of anomalous septal and parietal bands, producing DCRV with a good-sized main pulmonary artery and c...

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Double-chambered left ventricle in an adult: diagnosis by CMRI

Cited by 26 publications

References 10 publications

Double‐chambered left ventricle diagnosis by 2D and 3D echocardiography: From fetus to birth

Double‐chambered left ventricle diagnosis by 2D and 3D echocardiography: From fetus to birth

Double-chambered left ventricle in a young previously healthy man presenting for a routine echocardiographic study (RCD code: IV-1B.2o)

Combined double-chambered right ventricle with double-chambered left ventricle: a rare anomaly

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