Website is intended for physicians
Search:

 

 

Abstract:

Background: case report of a rare congenital anomaly - the diverticulum of the right ventricle of the heart, revealed by echocardiography and magnetic resonance imaging (MRI) of the heart.

Aim: was to show possibilities in detection and differential diagnosis of diverticulum of the right ventricle.

Materials and methods: patient, 23 years, during examination after passed pneumonia, underwent echocardiography wich revealed an aneurysm of right ventricle. Patient underwent further examination: MRI of heart in T1-WS and T2-WS, «gradient echo» and dynamical regime (Cine-SSFP) in standard positions. Demonstration of diverticulum is based on reconstruction imaging (MPR). Results: due to MRI data, in right ventricle we found a bulging 1,2х2,0 cm with clear contours, wich decreased in systole with myocardum of right ventricle - «true diverticulum of right ventricle». We marked difficulties in the diagnosis associated with the paucity of clinical manifestations.

Conclusions: MRI made it possible to study individual morphological anatomy of the diverticulum, to demonstrate and to assess in detail the topography that helped to make decisions on further management of the patient. 

 

References

1.      Cavalle-Garrido T., Cloutier A., Harder J., et al. Evolution of fetal ventricular aneurysms and diverticula of the heart: an echocardiographic study. Am. J. Perinatol. 1997; 14:393-400.

2.      Krasemann T., Gehrmann J., Fenge H., et al. Ventricular aneurysm or diverticulum? Clinical differential diagnosis. Pediatr. Cardio. 2001; 22:409-411.

3.      Rodts-Palenik S., Barrilleaux S., Jeanty Ph. Diverticulum of the right ventricle http://www.sonoworld.com/ fetus/page.aspx?id=1474

4.      Bankl H. Congenital malformation of heart and great vessels: Synopsis of Pathology, Embryology, and Natural History. Urban and Schwarzenberg. 1977; 263.

5.      Cumming G.R. Congenital diverticulum of the right ventricle. Am. J. Cardiol. 1969; 23:297.

6.      Wax J.R., Moran A., Pinette M.G., et al. Prenatal sonographic diagnosis of fetal right ventricular diverticulum. J. Ultrasound Med. 2007; 26(2):267-270.

7.      Pressoir R., Downing J. W. Congenital diverticula of the right ventricle of the heart: A case report. Journal of the National Medical Association. 1980; 72, 3: 262-264.

8.      Sangawa K., Aoki A., Yoshino T. Resection of a right ventricular diverticulum of fibrous type by off-pump cardiac surgery; report of a case. Kyobu Geka. 2009; 62(2):152-156.

9.      Farnsworth P.B., Lefkowitz M., Shehadi W., et al. Spontaneous rupture of fibrous diverticulum of the right ventricle. Am .J. Dis. Child. 1972; 123:248-250.

10.    Freedom R.M., Yoo S.J., Mikailian H. Cardiac diverticulum and aneurysm. The Natural and Modified History of Congenital Heart Disease. Blackwell Publishing. 2003:475-478.

11.    Rajs J., Thoren C., Kjellman M. Spontaneous rupture of a congenital diverticulum of the right ventricle in a 1-month-old child. Eur. J. Cardiol. 1977; 16(2): 131-137.

12.    Benatar A., Vorsselmans A. Foetal right ventricular outpouching associated with ventricular bigeminy. OA Case Reports. 2013; 12; 2(6):51.

13.    Marijon E., Ou Ph., Fermont L., et al. Diagnosis and outcome in congenital ventricular diverticulum and aneurysm. J. Thorac. Cardiovasc. Surg. 2006; 131: 433-437.

14.    Hamaoka, K., Onaka M., Tanaka T. Congenital ventricular aneurysm and diverticulum in children. Pediatric Cardiology 1987; 8:169-175.

15.    Uhl H.S. A previously undescribed congenital malformation of the heart: almost total absence of the myocardium of the right ventricle. Bulletin of the JohnsHopkinsHospital. 1952; 91 (3): 197-209.

16.    Bharati S., Rowen M., Camarata S.J., et al. Diverticulum of the right ventricle. Arch. Pathol. 1975; 99:383-386.

17.    Carter J.B., Van Tassel R.A., Moller J.H., et al. Congenital diverticulum of the right ventricle. Association with pulmonary stenosis and ventricular septal defect. Am. J. Cardiol. 1971; 28:478.

18.    Cantrell J.R., Haller J.A., Ravitch M.M. A syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart. Surg, Gynecol, Obstet. 1958; 107:602-614.

19.    Okereke O.U., Cooley D.A., Frazier O.H. Congenital diverticulum of the ventricle. J. Thorac. Cardiovasc. Surg. 1986; 91:208-214.

20.    McAulife F.M., Hornberger L.K., Johnson J., et al. Cardiac diverticulum with pericardial effusion: report of two new cases treated by in utero pericardiocentesis and a review of the literature. Ultrasound Obstet. Gynecol. 2005; 25:401-404.

21.    Treistman B., Cooley D.A., Lufschanowski R., Leachman R.D. Diverticulum or aneurysm of left ventricle. Am. J. Cardiol. 1973; 32:119-123.

22.    Paronetto F., Strauss L. Aneurysm of the left ventricle due to congenital muscle defect in an infant: report of a case with discussion of pathogenesis of associated endocardial fibroelastosis. Am. J. Cardiol. 1963; 12:721-729.

23.    Archbold R.A., Robinson N.M., Mills P.G. Long-term follow-up of a true contractile left ventricular diverticulum. Am. J. Cardiol. 1999; 83:810-813.

24.    Hornberger L.K., Dalvi B., Benacerraf B. Prenatal sonographic detection of cardiac aneurysms and diverticula. J. Ultrasound Med. 1994; 13:967-970.

25.    Carrard C., Massardier J., Pangaud N. Fetal right ventricular diverticulum with pericardial effusion: report of a new case treated by in utero pericardiocentesis. Pediatr. Cardiol. 2010; 31(6):891-893.

26.    Bogaert J. Dymarkowski S., Taylor A.M. Clinical Cardiac MRI. Springer. 2005; 563.

27.    O’Donnell D.H., Abbara S., Chaithiraphan V., et al. Cardiac Tumors: Optimal Cardiac MR Sequences and Spectrum of Imaging Appearances. AJR. 2009; 193: 377-387.

28.    Finn J.P., Nael K., Deshpande V., et al. Cardiac MR imaging: state of the technology. Radiology. 2006; 241:338-354.

29.    Suilen C., Friedli B., Rutishauser W. Congenital intrathoracic left ventricular diverticulum in an adult. Chest. 1990; 98:750-751.

30.    Evans W., Madrid A., Castillo W., et al. All cardiac right ventricular outpouches are not created equal. Pediatr Cardiol. 2009; 30(7):954-957.

ANGIOLOGIA.ru (АНГИОЛОГИЯ.ру) - портал о диагностике и лечении заболеваний сосудистой системы