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Journal of Fetal Medicine

, Volume 6, Issue 4, pp 165–169 | Cite as

Prenatal Diagnosis of a Fetal Right Ventricular Diverticulum: A Case Report

  • Shalaka Arun BansodeEmail author
  • Bijoy Balakrishnan
  • Meenu Batra
  • P. S. Sreeja
  • Swapneel N. Patil
  • K. K. Gopinathan
Original Article
  • 9 Downloads

Abstract

Cardiac diverticulum is a rare anomaly. These are transmural localized protrusions, within the free wall of the ventricles. Diverticulum may be associated with pericardial effusion and complications such as pulmonary hypoplasia or hydrops fetalis. Pericardial effusion is the most frequently associated finding. Pericardial effusion should be considered as an indirect sign of the presence of cardiac diverticula. Delivery should be planned at a tertiary care center well equipped to deal with cardiac anomalies. Generally, the prognosis of the isolated cardiac diverticulum is excellent. We present a case of a prenatal diagnosis of right ventricular diverticulum at 20 weeks and 4 days of gestation associated with pericardial effusion. Spontaneous resolution of diverticulum and pericardial effusion was noted in the third trimester scan at around 35 weeks and 5 days. The baby was delivered at 39 weeks and 3 days of gestation by cesarean section for an obstetric indication. The baby was well at 1 year and 2 months of age at the time of writing. Fetal cardiac diverticulum if not associated with rhythm disturbance, signs of cardiac failure or other cardiac or extracardiac abnormality carries an excellent prognosis.

Keywords

Cardiac diverticulum Cardiac aneurysm Pericardial effusion Arrythmia Fetal hydrops 

Notes

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References

  1. 1.
    Carles D, Maugey-Laulom B, Habboud H, Alberti EM, Weichhold W, Leger F. Early prenatal diagnosis of ventricular diverticulum complicated by serous pericardial effusion. Prenat Diagn. 1995;15(8):778–80.CrossRefGoogle Scholar
  2. 2.
    Abi-Nader K, David AL, Yates R, Pandya P. Successful outcome after prenatal treatment of a cardiac diverticulum with massive pericardial effusion. Fetal Diagn Ther. 2009;25(1):148–52.CrossRefGoogle Scholar
  3. 3.
    Williams JA, Collardey KR, Treadwell MC, Owens ST. Prenatally diagnosed right ventricular outpouchings: a case series and review of the literature. Pediatr Cardiol. 2009;30(6):840–5.CrossRefGoogle Scholar
  4. 4.
    Baltaxe HA, Wilson WJ, Amiel M. Diverticulosis of the left ventricle. Am J Roentgenol. 1979;133(2):257–61.CrossRefGoogle Scholar
  5. 5.
    Cantrell JR, Haller JA, Ravitch MM. A syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart. Surg Gynecol Obstet. 1958;107(5):602–14.PubMedGoogle Scholar
  6. 6.
    Prefumo F, Bhide A, Thilaganathan B, Carvalho JS. Fetal congenital cardiac diverticulum with pericardial effusion: two cases with different presentations in the first trimester of pregnancy. Ultrasound Obstet Gynecol. 2005;25(4):405–8.CrossRefGoogle Scholar
  7. 7.
    Cavallé-Garrido T, Cloutier A, Harder J, Boutin C, Smallhorn JF. Evolution of fetal ventricular aneurysms and diverticula of the heart: an echocardiographic study. Am J Perinatol. 1997;14(7):393–400.CrossRefGoogle Scholar
  8. 8.
    Hallali P, Iung B, Davido A, Binet JP, Leriche H, Corone P. Congenital diverticulum of the right ventricle: report of two cases associated with other congenital heart defects. Am Heart J. 1989;117:957–9.CrossRefGoogle Scholar
  9. 9.
    Koshiishi T, Osada H, Hata A, Furugen Y, Urakoshi T, Mitsuhashi N. Prenatal rupture of right ventricular diverticulum: a case report and review of the literature. Prenat Diagn. 2007;27(12):1154–7.CrossRefGoogle Scholar
  10. 10.
    McAuliffe FM, Hornberger LK, Johnson J, Chitayat D, Ryan G. 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(4):401–4.CrossRefGoogle Scholar
  11. 11.
    Del Río M, Martínez JM, Bennasar M, et al. Prenatal diagnosis of a right ventricular diverticulum complicated by pericardial effusion in the first trimester. Ultrasound Obstet Gynecol. 2005;25(4):409–11.CrossRefGoogle Scholar
  12. 12.
    Ohlow M-A, Brunelli M, Lauer B. Characteristics and outcome of primary congenital left ventricular aneurysm and diverticulum: analysis of cases from the literature. Prenat Diagn. 2014;34(9):893–9.CrossRefGoogle Scholar
  13. 13.
    Ohlow MA, Lauer B, Brunelli M, Geller JC. Ventricular aneurysms are different from ventricular diverticula. Circ J. 2013;77(1):276.CrossRefGoogle Scholar
  14. 14.
    Nam KH, Kwon JY, Son GH, Cho NH, Park YW, Kim YH. Prenatally diagnosed left ventricular diverticulum with thoracoabdominal wall defect: a case and review of the literature. J Perinatol. 2010;30(11):760–2.CrossRefGoogle Scholar
  15. 15.
    Gowda M, Bharathi S, Thiagarajan M, Aneja T. Prenatal diagnosis of fetal right and left congenital ventricular aneurysms. J Matern Fetal Neonatal Med. 2017.  https://doi.org/10.1080/14767058.2017.1342799.CrossRefPubMedGoogle Scholar
  16. 16.
    Brachlow A, Sable C, Smith S, Slack M, Martin G. Fetal diagnosis and postnatal follow-up of an asyntomatic congenital Leith ventricular diverticulum. Pediatr Cardiol. 2006;23(6):658–60.CrossRefGoogle Scholar
  17. 17.
    Gardiner HM, Wimalasundera R, Pasquini L, Wawryk S, Ho SY. Images in cardiovascular medicine. Pericardiocentesis at 14 weeks: effective treatment of pericardial effusion complicating right ventricular diverticulum. Circulation. 2005;112(9):e120.CrossRefGoogle Scholar
  18. 18.
    Rodriguez GR, Rodriguez GA, Delgado GR, Gutierrez RL, Castellano MM, Hernandez GA. Prenatal diagnosis of cardiac diverticulum with pericardial effusion in the first trimester of pregnancy with resolution after early pericardiocentesis. Case Rep Obstet Gynecol. 2015. Article ID 154690.Google Scholar
  19. 19.
    Ohlow MA, von Korn H, Lauer B. Characteristics and outcome of congenital left ventricular aneurysm and diverticulum: analysis of 809 cases published since 1816. Int J Cardiol. 2015;185:34–45.CrossRefGoogle Scholar
  20. 20.
    Makkuni P, Kotler MN, Figueredo VM. Diverticular and aneurysmal structures of the left ventricle in adults: report of a case within the context of a literature review. Tex Heart Inst J. 2010;37(6):699–705.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Marijon E, Ou P, Fermont L, et al. Diagnosis and outcome in congenital ventricular diverticulumand aneurysm. J Thorac Cardiovasc Surg. 2006;131(2):433–7.CrossRefGoogle Scholar

Copyright information

© Society of Fetal Medicine 2019

Authors and Affiliations

  1. 1.Department of Fetomaternal medicine, Centre for Infertility Management and Assisted Reproduction (CIMAR)Edappal Hospitals Pvt LtdEdappal, MalappuramIndia
  2. 2.Department of Obstetrics and Gynecology, CIMAREdappal Hospitals Pvt LtdEdappal, MalappuramIndia

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