Ohlow Marc-Alexander, Brunelli Michele, Lauer Bernward
Department of Cardiology, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437, Bad Berka, Germany.
Prenat Diagn. 2014 Sep;34(9):893-9. doi: 10.1002/pd.4389. Epub 2014 May 15.
Congenital left ventricular aneurysm (LVA) and diverticulum (LVD) are rare cardiac anomalies. We aimed to analyse the characteristics and long-term outcome of prenatal diagnosed patients with LVA/LVD.
We performed a systematic review of the literature to identify and analyse patients diagnosed prenatally with LVA/LVD.
Twenty-six fetuses with prenatal diagnosis of LVA (50% male subjects) and 16 with LVD (38% male subjects) were identified. Fetal age at diagnosis was 23.8 ± 6.1 weeks. Mean maternal age was 30.6 ± 6.1 years old. LVA was larger (375 ± 237 vs 60 ± 71 mm(2); p = 0.002), and LVA/LVD was frequently observed in an apical location (62%). Associated cardiac/extracardiac defects were reported in 13/42 (31%). Symptomatic patients presented with arrhythmias (LVA 16% vs LVD 0%), hydrops fetalis (LVA 27% vs LVD 18.8%), or rupture (LVA 4% vs LVD 38%; p = 0.02). Size changes of the LVA/LVD during pregnancy were reported in 17%. Fetal death occurred in nine cases (21.4%); termination of pregnancy was performed in six cases (14.3%). All other babies were delivered at term. During follow-up (mean 29.1 ± 38.2 months), the rate of adverse events was significantly increased in patients with LVA (40 vs 0%; p = 0.04) CONCLUSION: The rate of fetal complications including fetal death is high. Long-term outcome among the survivors is significantly worse in patients with LVA.
先天性左心室动脉瘤（LVA）和憩室（LVD）是罕见的心脏异常。我们旨在分析产前诊断为LVA/LVD患者的特征和长期预后。
我们对文献进行了系统回顾，以识别和分析产前诊断为LVA/LVD的患者。
确定了26例产前诊断为LVA的胎儿（50%为男性）和16例LVD胎儿（38%为男性）。诊断时的胎儿年龄为23.8±6.1周。母亲平均年龄为30.6±6.1岁。LVA更大（375±237 vs 60±71mm²；p = 0.002），且LVA/LVD常位于心尖部（62%）。13/42（31%）报告有相关心脏/心脏外缺陷。有症状的患者表现为心律失常（LVA为16% vs LVD为0%）、胎儿水肿（LVA为27% vs LVD为18.8%）或破裂（LVA为4% vs LVD为38%；p = 0.02）。17%报告了孕期LVA/LVD的大小变化。9例（21.4%）发生胎儿死亡；6例（14.3%）进行了引产。所有其他婴儿均足月分娩。在随访期间（平均29.1±38.2个月），LVA患者的不良事件发生率显著增加（40% vs 0%；p = 0.04）。结论：包括胎儿死亡在内的胎儿并发症发生率很高。LVA患者幸存者的长期预后明显更差。
