Wiegand Gesa, Rauch Ralf, Singer Helmut, Koch Andreas, Hofbeck Michael
Department of Pediatric Cardiology, University Children's Hospital, Hoppe-Seyler-Strasse 1, 72076, Tuebingen, Germany,
Pediatr Cardiol. 2014 Aug;35(6):983-9. doi: 10.1007/s00246-014-0885-7. Epub 2014 Feb 28.
Right-ventricular diverticula (RVD), although rare, have particular characteristics. Our study describes the morphology of anterosuperior diverticula of the right ventricle (RV) and patient outcome for this anomaly. Retrospective analysis was performed on all patients with anterosuperior RVD diagnosed in two tertiary referral centres. From January 1982 to December 2012, five patients were diagnosed with anterosuperior RVD (median 4 months). Four patients had perimembranous ventricular septal defects (VSDs) with no clinical symptoms related to RVD. Communication of the RVD with the RV was located either close to the VSD (two patients) or in the anterior free wall of the RV opposite the VSD (two patients). In the remaining patient, the diverticulum was connected with the left ventricle (LV) by a tunnel-like structure originating from the left-ventricular outflow tract; the RVD communicated with the RV by way of a restrictive opening. Four patients underwent surgical repair including patch closure of the VSD (one patient) and patch closure of the VSD through an incision of the RVD followed by plication of the diverticulum or closure of its communication with the RV (three patients). All patients remained asymptomatic during a median follow-up of 14.8 years. Anterosuperior RVD is a specific congenital cardiovascular anomaly frequently associated with additional congenital heart disease. There are significant variations in how the RVD communicates with the RV with each requiring a different surgical repair strategy. According to the experience in our small cohort, the long-term prognosis of patients with anterosuperior RVD appears excellent after surgical correction of associated congenital heart disease.
右心室憩室（RVD）虽然罕见，但具有特殊特征。我们的研究描述了右心室（RV）前上憩室的形态以及该异常情况患者的预后。对在两个三级转诊中心诊断出的所有前上型RVD患者进行了回顾性分析。从1982年1月至2012年12月，共诊断出5例前上型RVD患者（中位时间为4个月）。4例患者伴有膜周部室间隔缺损（VSD），但无与RVD相关的临床症状。RVD与RV的连通部位要么靠近VSD（2例患者），要么在RV与VSD相对的前游离壁（2例患者）。在其余1例患者中，憩室通过源自左心室流出道的隧道样结构与左心室（LV）相连；RVD通过一个限制性开口与RV相通。4例患者接受了手术修复，包括VSD补片修补术（1例患者）以及通过RVD切口进行VSD补片修补术，随后折叠憩室或闭合其与RV的连通口（3例患者）。所有患者在中位随访期14.8年期间均无症状。前上型RVD是一种特定的先天性心血管异常，常伴有其他先天性心脏病。RVD与RV的连通方式存在显著差异，每种情况都需要不同的手术修复策略。根据我们小样本队列的经验，在对相关先天性心脏病进行手术矫正后，前上型RVD患者的长期预后似乎良好。
