Halpern Lloyd, Garabedian Carl, Worrall Neil K
Pediatric Anesthesiologist, Shriner's Hospital for Children, 911 W. 5TH Avenue Spokane, Washington 99204, USA.
Pediatric Cardiologist, Providence Sacred Heart Children's Hospital, 101 W. 8th Avenue Spokane, Washington 99204, USA.
Case Rep Cardiol. 2018 Nov 11;2018:5839432. doi: 10.1155/2018/5839432. eCollection 2018.
A pouch protruding from the free wall of the left ventricle may be either a congenital ventricular diverticulum (CVD) or aneurysm (CVA). Being aware of these rare congenital anomalies is critical in making the diagnosis. Differentiating the two is important for treatment decisions. We describe a patient with dextrocardia, Tetralogy of Fallot, and a congenital left ventricular apical diverticulum diagnosed following the induction of anesthesia. CVD and CVA may present in the antenatal period through late adulthood with differing morphology, location, and symptoms. Echocardiography is paramount in the diagnosis and characterization of these lesions. If this anomaly is encountered after the induction of anesthesia or during intraoperative echocardiography, the cardiothoracic anesthesiologist should make the surgical team aware so it can be further characterized and a treatment plan made prior to incision.
从左心室游离壁突出的囊袋可能是先天性心室憩室（CVD）或动脉瘤（CVA）。认识到这些罕见的先天性异常对于做出诊断至关重要。区分两者对于治疗决策很重要。我们描述了一名患有右位心、法洛四联症和先天性左心室心尖憩室的患者，该患者在麻醉诱导后被诊断出来。CVD和CVA可能在产前至成年后期出现，具有不同的形态、位置和症状。超声心动图对于这些病变的诊断和特征描述至关重要。如果在麻醉诱导后或术中超声心动图检查时遇到这种异常，心胸麻醉医生应告知手术团队，以便进一步明确其特征并在切开前制定治疗方案。
