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Congenital diverticulum of the left ventricle. Report of two unusual cases
Insights
Two infants with congenital cardiac diverticula showed unique presentations. One had a submitral diverticulum with mitral incompetence, while the other had an apical diverticulum requiring mitral valve replacement.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Imaging
Background:
- Congenital cardiac diverticula are rare malformations.
- Understanding their varied presentations and associated cardiac defects is crucial for diagnosis and management.
Observation:
- Two infants presented with congenital cardiac diverticula.
- One infant had a submitral valvular diverticulum associated with mitral incompetence and impaired left ventricular function.
- The second infant presented with an isolated apical left ventricular diverticulum, severe mitral incompetence, and intractable congestive heart failure.
Findings:
- Echocardiography and angiography confirmed the diverticula.
- The infant with apical diverticulum underwent successful mitral valve replacement due to a dysplastic, fibrotic mitral valve with myxomatous features.
- A potential association between congenital mitral disease and congenital apical diverticular, possibly influenced by race and sex, was noted.
Implications:
- This case series highlights the diverse clinical manifestations of congenital cardiac diverticula.
- It underscores the importance of comprehensive cardiac evaluation, including advanced imaging, in affected infants.
- The findings suggest a possible link between specific types of congenital diverticula and mitral valve abnormalities, warranting further investigation.
Abstract:
Of two infants with congenital cardiac diverticula one had a defect consisting of a submitral valvular diverticulum rather than the expected aneurysm. It was clearly shown by echocardiography as well as angiography and was associated with moderate mitral incompetence and a poorly functioning left ventricular wall. The second infant had an isolated apical left ventricular diverticulum with subnormal left ventricular function and severe mitral incompetence. Because of intractable congestive heart failure this infant underwent successful replacement of a dysplastic fibrotic mitral valve which on histological examination had myxomatous features. The association between congenital mitral disease and congenital apical diverticular may be related to race and sex.