Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2010;37(5):584-6.

Left ventricular diverticulum mimicking ventricular pseudoaneurysm in an adult

Hisham M F Sherif  1 , Hersh S Maniar, Nicholas Spadea, Michelle Marge, Michael K Banbury
Affiliations
Case Reports

Left ventricular diverticulum mimicking ventricular pseudoaneurysm in an adult

Hisham M F Sherif et al. Tex Heart Inst J. 2010.

Abstract

True diverticulum of the left ventricle is very rarely seen in adults: the condition typically occurs in children and can be associated with other anatomic defects that involve the thoracoabdominal midline. Left ventricular diverticulum, which is usually asymptomatic and typically discovered incidentally, can pose a substantial challenge to the surgeon.Herein, we report the case of a 46-year-old man who presented with worsening exertional angina and ST-segment elevation in the inferior electrocardiographic leads. After a stent was deployed in the patient's occluded right coronary artery, left ventriculography revealed outward pouching of the left ventricular inferior wall, suggesting an aneurysm or a contained free-wall rupture. Transesophageal echocardiography showed a sizable defect and a possible intracavitary thrombus. The presumptive diagnosis was a postinfarction subacute pseudoaneurysm of the left ventricle. However, during surgery, we saw no clots, intrapericardial blood accumulation, or perforation. A localized area of thinned muscle in the region of the posterior descending coronary artery was consistent with a ventricular diverticulum. The left ventricular epicardial surface was reinforced with a small bovine pericardial patch. The patient's recovery was uneventful. We discuss the forms of congenital left ventricular diverticulum and offer considerations regarding differential diagnosis.

Keywords: Diagnosis, differential; diverticulum/congenital/diagnosis/physiopathology; heart defects, congenital/diagnosis; heart ventricles/abnormalities; treatment outcome.

PubMed Disclaimer

Figures

None
Fig. 1 Preoperative left ventriculography reveals a filling defect in the inferior wall of the left ventricle (arrow).
None
Fig. 2 Preoperative transesophageal echocardiogram shows a cavity, suggesting a pseudoaneurysm, in the inferior wall of the left ventricle (arrows).
None
Fig. 3 Intraoperative transesophageal echocardiogram shows a filling defect in the inferior wall of the left ventricle (arrow).
None
Fig. 4 Intraoperative photograph shows a normal inferior surface of the left ventricle. A localized area of thinned myocardium has been highlighted with a surgical marking pen (arrow).
See this image and copyright information in PMC

References

    1. Peacock TB. On malformations of the human heart. 2nd ed. London: Churchill & Sons; 1866.
    1. Mardini MK. Congenital diverticulum of the left ventricle. Report of two unusual cases. Br Heart J 1984;51(3):321–6. - PMC - PubMed
    1. Suilen C, Friedli B, Rutishauser W. Congenital intrathoracic left ventricular diverticulum in an adult. Chest 1990;98(3): 750–1. - PubMed
    1. Walton-Shirley M, Smith SM, Talley JD. Left ventricular diverticulum: case report and review of the literature. Cathet Cardiovasc Diagn 1992;26(1):31–3. - PubMed
    1. Vazquez-Perez J, Gautier M, Mercier JN, Belaisch G, Nouaille J. Diverticulum of the left ventricle (apropos of 3 cases) [in French]. Arch Mal Coeur Vaiss 1969;62(7):922–40. - PubMed

Publication types

MeSH terms