Congenital right ventricular diverticulum formed by pulmonary regurgitative jet flow in a fetus with tetralogy of Fallot and absent pulmonary valve

Cardiovasc Pathol. 2021 Jan-Feb:50:107295. doi: 10.1016/j.carpath.2020.107295. Epub 2020 Sep 28.

Abstract

Congenital ventricular diverticulum is a rare anomaly with an unclear pathology. Here, we report a male fetus at 24 weeks of gestation, diagnosed with right ventricular diverticulum associated with tetralogy of Fallot and absent pulmonary valve. The diverticulum was located at the anterosuperior wall of the right ventricle and faced into the massive pulmonary regurgitation flow jet. Intrauterine fetal death from heart failure resulted at 26 weeks of gestation. An autopsy revealed significant subendocardial fibrosis in the diverticular wall without inflammatory cell infiltration. Clinical and pathologic features suggested that the regurgitative blood flow contributed to the formation of the right ventricular diverticulum.

Keywords: RV diverticulum; absent pulmonary valve; fetal echocardiogram; tetralogy.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Autopsy
  • Diverticulum / congenital*
  • Diverticulum / diagnostic imaging
  • Diverticulum / physiopathology
  • Echocardiography, Doppler, Color
  • Fatal Outcome
  • Fetal Death / etiology
  • Fetal Heart / abnormalities*
  • Fetal Heart / diagnostic imaging
  • Fetal Heart / physiopathology
  • Gestational Age
  • Heart Failure / etiology
  • Heart Failure / physiopathology
  • Heart Ventricles / abnormalities*
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology
  • Hemodynamics*
  • Humans
  • Male
  • Pulmonary Circulation*
  • Pulmonary Valve / abnormalities*
  • Pulmonary Valve / diagnostic imaging
  • Pulmonary Valve / physiopathology
  • Tetralogy of Fallot / complications*
  • Tetralogy of Fallot / diagnostic imaging
  • Tetralogy of Fallot / physiopathology
  • Ultrasonography, Prenatal