Document Detail


Left ventricular diverticulum mimicking ventricular pseudoaneurysm in an adult.
MedLine Citation:
PMID:  20978576     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
True diverticulum of the left ventricle is very rarely seen in adults: the condition typically occurs in children and can be associated with other anatomic defects that involve the thoracoabdominal midline. Left ventricular diverticulum, which is usually asymptomatic and typically discovered incidentally, can pose a substantial challenge to the surgeon.Herein, we report the case of a 46-year-old man who presented with worsening exertional angina and ST-segment elevation in the inferior electrocardiographic leads. After a stent was deployed in the patient's occluded right coronary artery, left ventriculography revealed outward pouching of the left ventricular inferior wall, suggesting an aneurysm or a contained free-wall rupture. Transesophageal echocardiography showed a sizable defect and a possible intracavitary thrombus. The presumptive diagnosis was a postinfarction subacute pseudoaneurysm of the left ventricle. However, during surgery, we saw no clots, intrapericardial blood accumulation, or perforation. A localized area of thinned muscle in the region of the posterior descending coronary artery was consistent with a ventricular diverticulum. The left ventricular epicardial surface was reinforced with a small bovine pericardial patch. The patient's recovery was uneventful. We discuss the forms of congenital left ventricular diverticulum and offer considerations regarding differential diagnosis.
Authors:
Hisham M F Sherif; Hersh S Maniar; Nicholas Spadea; Michelle Marge; Michael K Banbury
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  37     ISSN:  1526-6702     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2010  
Date Detail:
Created Date:  2010-10-27     Completed Date:  2011-02-11     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  584-6     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Christiana Hospital, Christiana Care Health System, Newark, Delaware 19718, USA. hsherif@christianacare.org
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, False / diagnosis*
Animals
Cardiac Surgical Procedures
Cattle
Diagnosis, Differential
Diagnostic Errors / prevention & control*
Diverticulum / diagnosis*,  surgery
Echocardiography, Transesophageal
Electrocardiography
Heart Aneurysm / diagnosis*
Heart Diseases / diagnosis*,  surgery
Heart Rupture, Post-Infarction / diagnosis*
Humans
Male
Middle Aged
Pericardium / transplantation
Radionuclide Ventriculography
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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