Isolated Congenital Left Ventricular Diverticulum in an Adult

Ichikawa, Kazuhito; Makino, Katsutoshi; Futagami, Y; Fujioka, Hirofumi; M, Ito; Hamada, Masayuki; Konishi, Tokuji; Nakano, Takeshi

doi:10.1177/000331979404500811

Cited by 37 publications

(16 citation statements)

References 8 publications

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“…Because our patient had no complications associated with his left ventricular diverticulum, he was managed conservatively with anticoagulant therapy. A fibrous left ventricular diverticulum has a higher possibility of complications such as systemic thromboembolizm or rupture than the muscular type [2,5,6,8,10]. Therefore, in this patient, we should be cautious for complications associated with his left ventricular diverticulum and recommend surgical resection if they occur.…”

Section: Discussionmentioning

confidence: 92%

A case of left ventricular diverticulum: Change of characteristics after myocardial infarction and usefulness of cardiac computed tomography

Mori¹,

Nagata²,

et al. 2010

Journal of Cardiology Cases

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A 72-year-old man with an old myocardial infarction was admitted to our hospital for cardiac reexamination. He had suffered from an inferior myocardial infarction when he was 60-year-old. The left ventriculogram had then shown a small contractile diverticulum at the apical portion of the left ventricle. Anterior myocardial infarction had recurred when he was 63-year-old. The left ventriculogram performed after the anterior myocardial infarction revealed that the diverticulum had become dilated and non-contractile. On admission, electrocardiography and chest X-ray showed no remarkable changes from the previous studies. Cardiac computed tomography (CT) demonstrated an apical left ventricular diverticulum with narrow communication to the main chamber and myocardial discontinuity of the wall at the site of the diverticulum. Tc-99m tetrofosmin myocardial images showed a perfusion defect in the apex. We presumed that a muscular left ventricular diverticulum had changed to the fibrous type after the anterior myocardial infarction. Cardiac CT imaging provides accurate evaluation of the left ventricular diverticulum and is useful for the differentiation between a left ventricular diverticulum and an aneurysm.

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Section: Discussionmentioning

confidence: 92%

A case of left ventricular diverticulum: Change of characteristics after myocardial infarction and usefulness of cardiac computed tomography

Mori¹,

Nagata²,

et al. 2010

Journal of Cardiology Cases

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“…In a cardiac catheterization study, the incidence of a left ventricular diverticulum was 0.26% (12). Another large retrospective echocardiographic study showed a prevalence of a left ventricular diverticulum of 0.04% (13).…”

Section: Discussionmentioning

confidence: 97%

“…Fibrous diverticula with a narrow neck are commonly located in the subvalvular area and are often associated with valvular incompetence (19). A fibrous left ventricular diverticulum is associated with a higher probability of complications, such as systemic thromboembolism or rupture, than the muscular type (12). On a plain chest radiogram, deviation of the heart border, abnormal cardiac contour, and cardiomegaly may be observed, depending on the size of the diverticulum.…”

Section: Discussionmentioning

confidence: 99%

Association between myocardial hypertrophy and apical diverticulum: more than a coincidence?

Sivrioğlu¹,

Sağlam²,

Öztürk³

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to investigate the possible association between the myocardial hypertrophy and the development of an apical diverticulum. MATERIALS AND METHODSWe retrospectively reviewed 786 multidetector computed tomography (MDCT) coronary angiography examinations (520 males, 266 females; mean age, 57±15 years; age range, 18-78 years). The end-diastolic left ventricle wall thickness was measured in all patients, and a wall thickness of 11 mm was determined to be the cut-off value for myocardial hypertrophy. The ventricular apex and subvalvular area were evaluated for ventricular diverticula. The difference between the apical diverticula in patients with and without myocardial hypertrophy was determined. RESULTSThere were 12 myocardial hypertrophy and nine apical diverticulum cases. Myocardial hypertrophy was observed in four (44%) of nine patients who had apical diverticula, and an apical diverticulum was observed in four (33%) of 12 patients who had myocardial hypertrophy. There was statistically significant difference for myocardial wall thickness between the apical diverticula in patients with myocardial hypertrophy and those without myocardial hypertrophy (P = 0.011). CONCLUSION Diagnosis of apical diverticula has become easier by using imaging modalities such as MDCT. There may be an association between myocardial hypertrophy and apical diverticulum.A pical diverticula are rare cardiac abnormalities consisting of a localized outpouching from the apex of the left ventricle. They are primarily congenital, occurring in isolation or in association with other abnormalities. Noncongenital cases are also seen in an isolated form in adults. A few cases have been described in which there is apparently an association between myocardial hypertrophy and apical diverticula (1-4).Recently, multidetector computed tomography (MDCT) has become a major diagnostic tool in cardiac imaging, showing both the coronary arteries and other cardiac and extracardiac structures, such as the myocardium, cardiac chambers, major vessels, and mediastinum (5). In this study, we investigated the association between myocardial hypertrophy and the development of apical diverticula. Materials and methods Patient selectionWe retrospectively reviewed 786 MDCT coronary angiography examinations performed in our department between October 2009 and May 2012, for the presence of apical diverticula.The institutional ethics committee approved this retrospective study (No: 2012-77 GATA Haydarpaa Teaching Hospital, ‹stanbul, Turkey). Written informed consent was obtained from all patients. Overall, there were 520 men and 266 women, with ages ranging from 18 to 78 years (mean, 57±15 years). The indications for MDCT coronary angiography were suspected coronary artery disease (n=681), coronary artery anomaly (n=36), coronary artery stent patency (n=27), and coronary artery bypass graft assessment (n=42). ImagingThe MDCT coronary angiography examinations were performed using a 64-MDCT scanner (Brilliance-64, Phillips Medical Systems, Eindh...

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“…Diverticulum is very rare especially in adults. The incidence was reported to be about 0.4 percent in an autopsy series of adult patients with cardiac death (6). They may be asymptomatic or may present with systemic embolization, heart failure, valvular regurgitation, ventricular disrhythmia, rupture and sudden death (7,8).…”

Section: Introductionmentioning

confidence: 99%

An Asymptomatic Left Ventricular Diverticulum

et al. 2007

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Congenital ventricular diverticulum is defined as a protrusion of the free wall of the ventricle, including endocardium, myocardium and pericardium. They have been classified in fibrous and muscular types. Congenital ventricular diverticulum may be asymptomatic or may be present with various clinical symptoms. Diverticulum is commonly seen in childhood, and fibrous type being the most common type. Muscular type is very rare seen in adults. We report here, a case with muscular type asymptomatic congenital left ventricular diverticulum in a 65 year-old female.

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Isolated Congenital Left Ventricular Diverticulum in an Adult

Cited by 37 publications

References 8 publications

A case of left ventricular diverticulum: Change of characteristics after myocardial infarction and usefulness of cardiac computed tomography

A case of left ventricular diverticulum: Change of characteristics after myocardial infarction and usefulness of cardiac computed tomography

Association between myocardial hypertrophy and apical diverticulum: more than a coincidence?

An Asymptomatic Left Ventricular Diverticulum

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