Saccular Elongation of the Left Ventricle into the Abdominal Wall with Persistence of the Anterior Mesocardium and Ventricular Septal Defect

Snellen, H. A.; Dankmeijer, J; Bruins, Miss C.; Collister, Miss R.M.

doi:10.1159/000165236

Cited by 17 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The " trunk-like " prolongation towards the umbilicus was an extension of the left ventricle. This was true, also, of a male infant described by Snellen et al (1952). In this case there was a persistent anterior mesocardium and a high ventricular septal defect.…”

mentioning

confidence: 59%

“…It follows that persistence of a ventral mesocardium is indicative of a defect occurring before the end of the fourth week. Snellen et al (1952) carefully studied the pericardial reflections in their case and demonstrated prolongations of the pericardial cavity, one lying behind and one on either side of the muscular tube. The anterior surface of the myocardial tube was not covered by pericardium, but a ventral mesocardium was clearly recognized.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Ventricular Extension Into the Abdominal Wall

Parsons¹

1957

Heart

View full text Add to dashboard Cite

In a previous paper mention was made of a girl with cyanotic congenital heart disease and a pulsatile tumour under the umbilicus (Astley and Parsons, 1953). This child died in Birmingham Children's Hospital in 1950, but the condition was thought to be a chance monstrosity until 1952, when Dr. Helen Taussig referred in a letter to another example of this condition. In 1955 both Dr. Catherine Neill and Dr. James Brown drew my attention to descriptions of other similar cases. CASE REPORT M. A., the fifth child of a healthy family, was born after a pregnancy complicated by a small hkmorrhage at the third month. A pulsating swelling at the umbilicus was noticed at birth; intermittent cyanosis was first observed six months later. Cyanotic attacks became increasingly severe and frequent, especially when feeding or crying, and she was unconscious when, at the age of 18 months, she was admitted to hospital for the last time in one of these attacks. She was quite well-developed, and uniformly cyanosed, with moderate clubbing of fingers and toes (hkmoglobin, 14-7 g.; red blood corpuscles, 6-8 million). The venous pressure was raised, the liver enlarged, and the lungs slightly congested. Arterial pulses were normal, and the blood pressure in the arms 120/?100 mm. Apical impulses could be felt in the fourth left intercostal space just internal to the mid-clavicular line, and in the fifth right space in the mid-clavicular line; the chest was not deformed. A systolic thrill was felt at the right sternal margin in the second and third spaces and a harsh systolic murmur was heard all over the front of the chest, and faintly between the scapulk. A systolic thrill and a continuous murmur could be detected over a smoothly-rounded, pulsatile swelling immediately deep to the umbilicus. A straight cord, which also pulsated, ran under the skin between the epigastric notch and the upper border of the tumour. The depth of cyanosis was not affected by compressing the tumour or its connections. X-ray examination supported a diagnosis of dextrocardia, but an electrocardiogram, using only the standard limb leads, showed peaked P waves in lead II, marked left axis deviation, and rather wide ventricular complexes, suggesting the possibility of tricuspid atresia with a diminutive right ventricle. No further investigations were possible until after death, when radioopaque material injected into the superior vena cava demonstrated a communication between right and left atria, and outlined the pulmonary veins. An injection into the sub-umbilical tumour showed connections with the aorta and its branches through a ventricle.Necropsy. The only abnormalities were those related to the heart. Externally (Fig. 1) the aorta and pulmonary artery appeared to arise from two ventricles separated by an interventricular groove; the right atrium was dilated. The apex of the heart was fusiform and continued downward as a muscular tube " like an anteater's snout " to an ovoid tumour (27 x 18 x 10 mm.) lying deep to the umbilicus. Unfortunately the reflections of th...

show abstract

mentioning

confidence: 59%

mentioning

confidence: 99%

Ventricular Extension Into the Abdominal Wall

Parsons¹

1957

Heart

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 87%

“…Skapinker resected the diverticulum in his case, an operation that had previously been reported only once (Roessler, 1944); but further cases treated in this way have since been reported by Potts et al (1953) andBailey (1955). Other recent reports are by Formijne (1950), Snellen et al (1952), and Parsons (1957).Included in the following description of a patient, in whom surgical resection was successfully undertaken, are electrocardiographic and manometric observations not hitherto recorded. The latter are possibly relevant to the mechanism of rupture of such diverticula, an accident known to have been the cause of death in at least three of the published cases.…”

mentioning

confidence: 88%

Congenital Diverticulum of the Left Ventricle

Lowe¹,

Williams²,

Robb³

et al. 1959

Heart

View full text Add to dashboard Cite

Congenital diverticula of the ventricles are rare and Skapinker (1951) was able to collect only twelve reported cases. In most of these, as in Skapinker's own patient, the diverticulum arose from the left ventricle but in two it communicated with both ventricles. Skapinker resected the diverticulum in his case, an operation that had previously been reported only once (Roessler, 1944); but further cases treated in this way have since been reported by Potts et al. (1953) and Bailey (1955). Other recent reports are by Formijne (1950), Snellen et al. (1952), and Parsons (1957).Included in the following description of a patient, in whom surgical resection was successfully undertaken, are electrocardiographic and manometric observations not hitherto recorded. The latter are possibly relevant to the mechanism of rupture of such diverticula, an accident known to have been the cause of death in at least three of the published cases. CASE REPORTThe patient, an eight-year-old girl, was referred for surgical treatment of a pulsatile epigastric mass which, because of its superficial position, was considered to be a potential threat to her in the event of trauma. The pulsation had been present at birth and was at that time associated with an umbilical hernia. When she was one year old the hernia had been repaired, the surgeon noting what he took to be an anomalous artery passing up from the epigastrium to disappear under the right costal margin. Visible epigastric pulsation had since persisted without change and without related symptoms. In addition cyanotic congenital heart disease with isolated dextrocardia had been recognized in the neonatal period and the patient had had nonprogressive slight cyanosis and impairment of effort tolerance throughout her life. At the age of eight she was able to run no further than thirty yards. She did not squat and there had been no attacks of severe cyanosis or unconsciousness. The family history and history relating to the maternal pregnancy revealed no unusual features.Examination showed a thin girl, rather small for her age, with slight central cyanosis and finger clubbing. Physical findings relating to the heart argued for pulmonary hypertension rather than pulmonary stenosis as the cause of shunt reversal; and these, together with the radiographic demonstration of isolated dextrocardia with a left-sided aortic arch and pulmonary vascularity verging on the upper limit of normal (Fig. 1) and the electrocardiogram, consistent in this context with right ventricular hypertrophy (Fig. 4), pointed to a clinical diagnosis of the Eisenmenger complex with dextrocardia. This was supported by the results of cardiac catheterization which included a pulmonary arterial pressure of 112/64 mm. Hg, reduction of brachial arterial oxygen saturation to 88 per cent, and a rise in oxygen saturation from 65 per cent in the superior vena cava and right atrium to 70 per cent in the right ventricle and pulmonary artery.In the epigastrium there was a pulsatile structure which extended upwards from just above the...

show abstract

Congenital Diverticulum of the Left Ventricle

Norton¹

1973

Arch Pediatr Adolesc Med

View full text Add to dashboard Cite

Saccular Elongation of the Left Ventricle into the Abdominal Wall with Persistence of the Anterior Mesocardium and Ventricular Septal Defect

Cited by 17 publications

References 0 publications

Ventricular Extension Into the Abdominal Wall

Ventricular Extension Into the Abdominal Wall

Congenital Diverticulum of the Left Ventricle

Congenital Diverticulum of the Left Ventricle

Contact Info

Product

Resources

About