ABSTRACT
Due to the rarity of congenital ventricular diverticula and aneurysms, their natural
history remains unclear. An excellent prognosis has been suggested for those cases
diagnosed during fetal life. From October 1992 to January 1996 seven fetuses were
diagnosed with ventricular diverticula or aneurysms. Gestational age ranged from 18
to 36 weeks. The indications for fetal echocardiogram were cardiomegaly, abnormal
four-chamber view, a large pericardial effusion, and hydrothorax. Echocardiography
revealed a moderate sized apical left ventricular aneurysm (2), a small sub-valvular
right ventricular diverticulum (1), small apical right ventricular diverticulum (2),
a large submitral left ventricular aneurysm (1), and a large diverticulum arising
from the lateral free wall of the left ventricle (1). Decreased left ventricular function
was detected in three fetuses with left ventricular aneurysms. Two fetuses with large
lesions, developed hydrops and died in utero. Postnatal echocardiograms confirmed
prenatal findings in all survivors. All infants remained asymptomatic, with age on
follow-up from 8 to 24 months. An accurate diagnosis of ventricular diverticula and
aneurysms is feasible prenatally. Outcome depends on the size and progression of the
lesion. The presence of a large pericardial effusion in three cases with a diverticula
was noted.
Keywords
Fetal heart - diverticulum - aneurysm - echocardiography
