Prenatal rupture of a left ventricular diverticulum: a case report and review of the literature

Abstract

Congenital left ventricular diverticulum is a rare malformation. We report a case of a ruptured congenital left ventricular diverticulum in a 24-week-old fetus. The fetus was referred for a large and circumferential pericardial effusion confirmed by cross-sectional echocardiography in our tertiary fetal cardiology unit. Pericardiocentesis removed 25 mL of old hematic fluid. The fetus died 5 days later. The pathological examination showed a ruptured submitral fibrous diverticulum of the posterior wall of the left ventricle. There is no previous report in the literature of prenatal rupture of a cardiac diverticulum. The submitral location and the fibrous wall of the diverticulum is uncommon. As regards this case, we reviewed the diagnostic criteria and the outcome of 11 cases of prenatal cardiac diverticulum reported in the literature.

Successful Outcome after Prenatal Treatment of a Cardiac Diverticulum with Massive Pericardial Effusion

“…It is important to distinguish them from aneurysms that have a large connection and which may have a more significant hemodynamic effect on the fetal heart. While diverticula tend to remain stable or decrease in size relative to the heart as gestation advances, aneurysms tend to increase in size with gestation [4] and are usually not associated with other anomalies [2] . Prenatally detected isolated congenital ventricular diverticula occur in association with a significant pericardial effusion.…”

Prenatal Diagnosis and Postnatal Follow‐up of a Congenital Fibrous Left Ventricular Diverticulum

“…Prenatal fetal echocardiography showed no cardiac diverticulum. A left ventricular diverticulum was identified at autopsy and appeared to be ruptured 6 . Only our case, which was located in the subaortic area, had a good outcome.…”

Isolated congenital left ventricular diverticulum in an elderly patient that was identified because of an incidental finding during a complete medical checkup

“…Cardiac or non-cardiac congenital malformations, such as septal defects, pulmonary stenosis or dextrocardia, and midline thoracoabdominal malformation syndrome, have been found in about 70% of patients with congenital ventricular diverticulum. Three general types of left ventricular diverticulum have been recognized: isolated muscular diverticula originating from the apex or base wall [4], multiple diverticula from the anterior or inferior wall, and large apical diverticula as a part of the midline thoracoabdominal malformation syndrome. Our patient belongs to the first group, that is, a single muscular diverticulum originating from the apex.…”