Prenatal Diagnosis of a Fetal Right Ventricular Diverticulum: A Case Report
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ORIGINAL ARTICLE
Prenatal Diagnosis of a Fetal Right Ventricular Diverticulum: A Case Report Shalaka Arun Bansode1 • Bijoy Balakrishnan1 • Meenu Batra1 • P. S. Sreeja1 Swapneel N. Patil1 • K. K. Gopinathan2
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Received: 1 June 2019 / Accepted: 30 September 2019 Ó Society of Fetal Medicine 2019
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.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40556-019-00222-w) contains supplementary material, which is available to authorized users. & Shalaka Arun Bansode [email protected] 1
Department of Fetomaternal medicine, Centre for Infertility Management and Assisted Reproduction (CIMAR), Edappal Hospitals Pvt Ltd, Edappal, Malappuram, Kerala 679576, India
2
Department of Obstetrics and Gynecology, CIMAR, Edappal Hospitals Pvt Ltd, Edappal, Malappuram, Kerala, India
Keywords Cardiac diverticulum Cardiac aneurysm Pericardial effusion Arrythmia Fetal hydrops
Introduction Congenital outpouching from the cardiac ventricular wall can be mainly considered as diverticulum or aneurysm. Since many cases are asymptomatic, the real incidence of these defects is unknown [1–3]. When an abnormal heart chamber is noted to be continuous with the ventricle on ultrasonography, it is important to distinguish between a ventricular diverticulum and aneurysm. Local weakening of the ventricular wall due to disturbance during embryonic development, myocardial infection and infarction are considered as causative factors [4]. Two types of diverticula are known: apical and nonapical [3, 5]; Apical diverticuli can be isolated and are usually not associated with other malformations; or multiple diverticula, which are located on the diaphragmatic or anterior surface of the ventricle or large apical diverticula, which are associated with midline thoracoabdominal malformations or
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