Hunter L E, Pushparajah K, Miller O, Anderson D, Simpson J M
Department of Congenital Heart Disease, Royal Hospital for Children, Glasgow, UK.
Department of Congenital Heart Disease, Evelina London Children's Hospital, London, UK.
Ultrasound Obstet Gynecol. 2016 Feb;47(2):236-8. doi: 10.1002/uog.15746.
Congenital left ventricular diverticulum (LVD) is a rare abnormality of the myocardium which has been detected previously in the fetus. Lesions have been reported from as early as 12 weeks' gestation but are more commonly detected in the mid-second trimester. Fetal presentation of LVD ranges from an abnormal four-chamber view of the heart, arrhythmia or isolated pericardial effusion to fetal hydrops with associated heart failure. Here, we describe the prenatal diagnosis of an infant with LVD originating from the left ventricular outflow tract associated with coarctation of the aorta. The diagnosis was confirmed postnatally by two-dimensional echocardiography and cardiac magnetic resonance imaging. We hypothesize that the lesion compromised antegrade flow into the transverse aortic arch, which may have contributed to underdevelopment of the aortic arch and subsequently the development of coarctation of the aorta. This is a unique case of LVD and coarctation of the aorta.
先天性左心室憩室(LVD)是一种罕见的心肌异常,此前已在胎儿中被检测到。早在妊娠12周时就有病变的报道,但更常见于妊娠中期。LVD的胎儿表现范围从心脏四腔视图异常、心律失常或孤立性心包积液到伴有心力衰竭的胎儿水肿。在此,我们描述了一例源于左心室流出道并伴有主动脉缩窄的LVD婴儿的产前诊断。产后通过二维超声心动图和心脏磁共振成像证实了诊断。我们推测该病变损害了进入横位主动脉弓的前向血流,这可能导致了主动脉弓发育不全,进而导致主动脉缩窄的发生。这是一例LVD合并主动脉缩窄的独特病例。