Prevalence and Outcome of Congenital Left Ventricular Aneurysms and Diverticula in an Adult Population

Abstract

Objectives: We sought to investigate the prevalence and clinical outcome of congenital left ventricular aneurysms (LVAs) and diverticula (LVD) in a large adult population. Methods: We retrospectively studied the left ventricular angiograms of 12,271 consecutive patients undergoing cardiac catheterization at our institution and analyzed the medical records of the patients. Results: The overall prevalence of LVA/LVD was 0.76% (94 patients): there were 42 patients with LVA (0.34%) and 52 patients with LVD (0.42%). Men were more likely to have LVA (62 vs. 38%), and women were more likely to have LVD (75 vs. 25%; p = 0.001 for both). The mean time of follow-up was 56 ± 6 months and was focused on clinical events, rehospitalization and survival. Mortality was 6% with no cardiac death. Patients with LVD were significantly more likely to have embolic events (p = 0.04). Patients with LVA and LVD were more likely to have rhythm disturbances compared with controls (p = 0.01 for both). Incidence of syncope was not different in both groups (p = 0.4 and 0.12, respectively). There was no reported incidence of rupture. Conclusion: This large single-center study suggests that the prevalence of LVA/LVD in adults is up to 20-fold higher than previously reported. One third of the affected patients in our series had nonfatal cardiovascular events during follow-up, with a predominance of embolic events in the LVD group.

Incidence and Prognosis of Ventricular Arrhythmias in Patients with Congenital Left Ventricular Aneurysms or Diverticula

“…8 The majority of these patients are free of symptoms. However, some patients may present with potentially life-threatening clinical conditions due to the presence of these disorders, such as ventricular tachyarrhythmias, congestive heart failure, and systemic embolic complications.…”

“…However, patients may present with cardiac arrhythmias, embolic complications, or heart failure. 8 There are only few observational case reports and small series on congenital left ventricular aneurysms and diverticula in the medical literature. [9][10][11][12][13][14] The association of this abnormality with ventricular tachyarrhythmia was reported in 1971 by Maloy et al 9 However, very little is known on the clinical outcome of these patients to date.…”

Case series: Congenital left ventricular diverticulum

“…[1] The prevalence of congenital ventricular diverticulum has been reported to be 0.42% among adult patients undergoing ventriculography after presenting to cardiac clinics with various symptoms. [2]…”

A Palpable Source of Stroke

“…3 The prevalence of congenital left ventricular outpouchings was 0.76% in a retrospective study of 12 271 adults undergoing left ventricular catheterization and found to have normal coronary arteries. 4 In that study, 5 of 79 patients, all of them with diverticula, suffered embolic stroke attributed to the diverticulum during a follow-up period of 56 months, suggesting that outpouchings present a significant risk of stroke. Other complications included arrhythmia and rupture.…”