Fernández A L, Montero J A, Alemany P, Martínez A
Cardiac Surgery Services, Hospital General de Valencia, Spain.
Int J Cardiol. 1996 Oct 25;56(3):223-6. doi: 10.1016/0167-5273(96)02743-x.
Diverticula of the left ventricle are rare and only a few cases have been documented in adults. They may be asymptomatic or may present with embolization, pain, endocarditis, or sudden death. We report the case of a 34-year-old woman who presented a cardiac arrest with ventricular fibrillation which required electrical cardioversion. She was found to have a left ventricular diverticulum associated with a subvalvar aortic stenosis. The diverticulum arose from the apex with a narrow connection to the ventricular cavity. A subvalvar fibrous ridge stenosis with a systolic pressure gradient of 115 mmHg was observed. Coronary angiography revealed normal coronary arteries. The diverticulum and the subvalvar fibrous ridge were resected. Histologic examination of the diverticulum wall demonstrated the presence of the three normal layers with marked muscle cell hypertrophy, atypical plexiform structure and fibrous endocardium. The pathophysioloy of diverticula associated with subvalvar aortic stenosis are discussed.
左心室憩室罕见，成人中仅有少数病例有文献记载。它们可能无症状，也可能表现为栓塞、疼痛、心内膜炎或猝死。我们报告一例34岁女性病例，该患者发生心脏骤停伴心室颤动，需进行电复律。发现她有一个与瓣下主动脉狭窄相关的左心室憩室。憩室起自心尖，与心室腔有狭窄连接。观察到瓣下纤维嵴狭窄，收缩期压力阶差为115 mmHg。冠状动脉造影显示冠状动脉正常。切除了憩室和瓣下纤维嵴。对憩室壁进行组织学检查，结果显示存在三层正常结构，伴有明显的肌细胞肥大、非典型的丛状结构和纤维性心内膜。本文讨论了与瓣下主动脉狭窄相关的憩室的病理生理学。
