Prenatal features and postnatal follow-up of congenital ventricular
outpouching: a retrospective study of two center in China.
Abstract
Objectives: Congenital ventricular outpouching (CVO) is a rare
cardiac malformation that can manifest as congenital ventricular
aneurysm (CVA) and/or congenital ventricular diverticula (CVD). In this
study, we describe the prenatal features and postnatal follow-up of 27
cases of CVO. Methods: The clinical data of 27 patients with
CVO who attended Sir Run Run Shaw Hospital Affiliated to the Medical
College of Zhejiang University (Zhejiang Province, China) and Taizhou
Hospital of Zhejiang Province Affiliated to Wenzhou Medical University
(Zhejiang Province, China) from April 2013 to October 2022 were
retrospectively analyzed. The patients were also followed up by
telephone. The prenatal characteristics and postnatal outcomes of the
patients with CVO were evaluated. Results: CVO was detected in
26 cases prenatally,, 14 (51.85%) were diagnosed with CVA, 9 (33.33%)
were diagnosed with CVD, 3 (11.11%) were equivocal for CVA/CVD, and 1
(3.70%) was detected with CVA postnatally. Six patients underwent
follow-up fetal echocardiography approximately 4 weeks after the initial
echocardiography examination, and a significant difference in CVO size
was observed between the two examinations ( P = 0.02). Eight
patients (29.63%) demonstrated cardiovascular dysfunction, and the
median CVO size in fetuses with and without cardiovascular dysfunction
was 205 (range: 169–396) mm 2 and 124 (range:
92–154.5) mm 2, respectively ( P = 0.01).
Eight patients (29.63%) had cardiac/extracardiac defects. Thirteen
patients were live born, 12 were terminated pregnancies, and 2 were lost
to follow-up. The postpartum size of the CVOs remained stable in six
patients, decreased in two patients, dissolved in three patients, and
were surgically removed in two patients. With the exception of one
patient with CVA complicated with complex congenital cardiac
malformation who underwent surgical treatment after birth and who had
postoperative left ventricular dysfunction (Case 1), the prognosis of
all of the patients was good. Conclusion: Most cases of fetal
CVO have typical echocardiographic manifestations of CVA or CVD, while
some cases manifest as a mixture of the two. The size of fetal CVO can
increase with the increase in gestational age. The occurrence of
cardiovascular dysfunction is related to the CVO size. Prenatal
echocardiography should examine changes in CVOs and the occurrence of
cardiovascular dysfunction. In general, the postpartum prognosis of
fetal CVO is good.