title: Diverticulum, or not Diverticulum, That Is the Question! Discussing About a Case of Left Ventricular Outpouching Associated With Bicuspid Aortic Valve Assessed by Cardiac Magnetic Resonance.
abstract: Congenital left ventricular outpouchings (LVOs) are infrequent myocardial malformations, comprising various overlapping abnormalities, whose characterization is often intricate in clinical practice using traditional non-invasive techniques. We describe a rare case of LVO associated with bicuspid aortic valve incidentally found in an asymptomatic adult patient. The LVO was located at basal level of the chamber, crescent-shaped with its largest diameter in short-axis view and presented a thin hypo-contractile wall without hyperintense areas on late gadolinium enhanced (LGE) images. This description corresponds to an overlap between usual definition of aneurism, fibrous and muscular diverticulum. The LVO was evaluated according with a classification recently proposed by Malakan Rad. In this case ventricular geometry was not respected, wall thickness was reduced and wall motion compromised therefore corresponding to a small IIc-type, which is considered having the poorest prognosis. Furthermore, the association with bicuspid aortic valve is very unusual. The patient refused surgery and preferred follow-up.
authors.affiliation: Department of Internal Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Capasso
authors.affiliation: Department of Cardiology, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Panelo
authors.affiliation: Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fiorelli
authors.affiliation: Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Carbone
authors.affiliation: Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Galea
keywords: Aortic Valve; Congenital Heart Disease; Diverticulum; Heart Aneurysm; Magnetic Resonance Imaging