Published online Dec 26, 2024. doi: 10.4330/wjc.v16.i12.760
Revised: September 30, 2024
Accepted: November 8, 2024
Published online: December 26, 2024
Processing time: 221 Days and 8.6 Hours
Ventricular diverticula are a rare congenital cardiac disorder presenting with an extremely low incidence. The presence of an apical diverticulum of the right ventricle has been associated with other congenital heart diseases such as tetralogy of Fallot. An important defining characteristic of ventricular diverticula that separates them from aneurysms through imaging techniques, is that they possess myocardial contraction synchronous to the adjacent walls, contributing to the ventricular stroke volume, so they do not usually require surgical treatment.
A 15-year-old male, currently asymptomatic, in follow up due to a pulmonary valve prosthesis placement and a history of corrected tetralogy of Fallot at 18 months old, underwent a cardiac magnetic resonance imaging in February 2024. A diverticulum was detected in the apical inferolateral wall of the right ventricle, which was not documented in the cardiac magnetic resonance imaging prior to valve prosthesis placement.
Right ventricular diverticula are a rare entity. To this date we could not find another case of a pulmonary valve placement, followed by a right ventricular diverticulum appearance.
Core Tip: Cardiac magnetic resonance imaging characterization is the gold standard for classifying anatomical abnormalities of the right ventricular wall. In asymptomatic patients, conservative management and close follow-up are recommended since no arrhythmias or thrombotic events occurred after the diverticulum was discovered; However, in some cases where there is a high risk of thrombosis (when the diverticulum is large or associated with arrhythmias or other malformations such as ventricular septal defect), anticoagulation is recommended. Surgery also is mainly reserved for cases of large and symptomatic diverticula.