Key result
Surgical treatment of congenital left ventricular diverticulum in four patients resulted in normal left ventricular morphology and cardiac function without adverse complications.
Why the study?
Whether congenital left ventricular diverticulum warrants active surgical removal or conservative follow-up in asymptomatic cases remains debated.
Does surgical treatment improve outcomes and restore cardiac function in patients with congenital left ventricular diverticulum?
Case Report (n=4)
No
Does surgical treatment improve outcomes and restore cardiac function in patients with congenital left ventricular diverticulum?
Answers are grounded in this paper and cite their sources.
Surgical resection of congenital left ventricular diverticulum is an effective and low-risk therapeutic option that restores normal cardiac morphology and function.
BACKGROUND: Congenital left ventricular diverticulum (LVD) is a rare cardiac malformation. Its prevalence rate is less than 0.1% of the congenital heart diseases requiring surgery. Some scholars suggest that all LVD should be actively removed to prevent possible risks, including diverticulum rupture, arterial embolism, and malignant arrhythmia. However, others believe that asymptomatic LVD can be followed up without immediate surgery. We reviewed and reported the diagnosis, clinical features, and surgical treatment of four cases of congenital LVD to provide clinical experience and a reference for the treatment of such patients. METHODS: Four patients (aged 3-32 years old) were diagnosed with congenital LVD and received surgical treatment at the Department of Cardiovascular Surgery of PLA General Hospital, Beijing, China from September 2009 to July 2019. All four patients had complete long-term postoperative follow-up data, including echocardiogram, enhanced cardiac computed tomography (CT), and electrocardiogram to monitor changes in left ventricular structure, heart function, and heart rhythm. RESULTS: In the first case, the fibrodiverticulum under the aortic valve squeezed the right ventricular outflow tract and the right main coronary artery; the morphology of the right ventricle and coronary artery returned to normal after surgery. The second patient was complicated with a huge lipoma in the apex of the left ventricle and underwent lipoma resection during LVD resection surgery. The third and fourth cases had muscular diverticula in the left ventricular apexes and received LVD removal surgery. All four patients recovered well after surgery and their left ventricular morphology and cardiac function were normal without adverse complications, such as atrial fibrillation, ventricular arrhythmia, and cerebrovascular accident. CONCLUSIONS: Although the morphology and character of congenital LVD were different in each case, the use of effective diagnostic and follow-up tools, including echocardiogram, enhanced CT, and magnetic resonance imaging (MRI), allowed for successful surgical treatment of the left ventricular diverticula and symptoms or other malformations. We propose that congenital LVD should be actively treated with surgery, especially considering effectiveness and low risk associated with this therapeutic option.
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Yao et al. (2021) conducted a case report in Congenital left ventricular diverticulum (n=4). Surgical treatment was evaluated on Postoperative recovery, left ventricular morphology, and cardiac function. Surgical treatment of congenital left ventricular diverticulum in four patients resulted in normal left ventricular morphology and cardiac function without adverse complications.
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