Double-chambered left ventricle characterized by CMR

A case series of double-chambered left ventricle detected by cardiovascular magnetic resonance

Background

Double-chambered left ventricle (DCLV) is a rare congenital condition, and few case reports are mentioned in literature. Entity, clinical course, and prognosis remain unclear. Cardiovascular magnetic resonance (CMR) is often used for characterization of various congenital heart diseases and can be particularly useful for imaging rare phenomena.

Case summary

Three cases of DCLV were detected by CMR within 2 years in our CMR centre with and without associated congenital heart disease or hypertrabecularization. The patients did not suffer from cardiac symptoms despite the presence of premature ventricular complexes in one patient. Diagnosis of DCLV was made based on a first CMR study that was performed in adulthood, although some anatomical suspicion was already raised by previous echocardiography.

Discussion

Double-chambered left ventricle, synonymous with the terminus 'cor triventriculare sinistrum', has been previously perceived as a rare phenomenon compared with double-chambered right ventricle. It has to be distinguished from ventricular aneurysm or cardiac diverticulum and is characterized by an additional contractile septum with normal wall structure that divides the LV cavum into two (rather) same-sized chambers. The prognosis seems to be benign, since there is no restriction in functionality and no increased thrombogenicity until adulthood. Consequently, there is (presumably) no need for a tailored therapy-at least in the cases present here. Accordingly, we recommend follow-up CMR examinations for progress monitoring and recognize CMR's significant role for diagnosis and follow-up of cardiac abnormalities in orphan diseases. Due to its broader availability, we expect further cases of DLVC in the future.

Two cases of six-chambered hearts

Double-chambered right ventricles (DCRV) and left ventricles are rare entities on their own. We present two cases with an unusual combination of double-chambered right as well as left ventricles. One was discovered in a 28-year-old female, while the other was found at birth in a female child. The differing nature of both the patient demographics as well as the presentation with a common morphological background is shown on both computed tomography and magnetic resonance imaging. The oldest description of an obstructive muscular band within the right ventricle was given in 1867. In the literature, there is ample description of the long-term prognosis and management guidelines for DCRV, but no inheritance patterns or risk factors have been identified except for associations with septal defects, tetralogy of Fallot and transposition of the great arteries. A combination of both double-sided left as well as right ventricles has been published in literature a few times with little details about management and prognosis. SIMILAR CASES PUBLISHED: Although many cases of DCRV and DCLV have been published, to our knowledge only 3 cases of combined DCRV and DCLV have been published in literature.

Double-chambered left ventricle diagnosis by 2D and 3D echocardiography: From fetus to birth

Double-chambered left ventricle (DCLV) is a rare cardiac anomaly and is characterized by the division of the left ventricle by abnormal muscle and/or fiber bundles into two chambers. We hereby report a fetus which was diagnosed with DCLV in utero by 2D and 3D Fetal echocardiography and the findings were confirmed after birth.