1
|
Moormann M, Vollroth M, Lacher M, Stepan H, Gräfe D, Thome U, Rützel S, Weidenbach M, Martynov I, Pügge C. Video of the Month: Pulsating Umbilicus in a Neonate with Left Ventricular Diverticulum. European J Pediatr Surg Rep 2024; 12:e54-e57. [PMID: 39363938 PMCID: PMC11449565 DOI: 10.1055/s-0044-1791569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 08/01/2024] [Indexed: 10/05/2024] Open
Abstract
Left ventricular diverticulum (LVD) is a rare malformation presenting in 0.05% of all congenital cardiac anomalies. It is associated with additional cardiac and extracardiac malformations. We report on a female neonate with prenatally diagnosed heterotaxia and dextrocardia who was born with a pulsating supraumbilical mass. Echocardiography revealed a diverticulum originating from the left ventricle, which was connected to the umbilicus. Magnetic resonance imaging confirmed an LVD without evidence of a diaphragmatic hernia on the day of life 9. The child underwent laparotomy/lower sternotomy, and the diverticulum and epigastric hernia were closed. The postoperative course was uneventful, and the girl was discharged on the 10th postoperative day. In a neonate with a pulsatile supraumbilical mass, the diagnosis of a congenital LVD should be taken into consideration. The treatment is straightforward and was successful in this single case.
Collapse
Affiliation(s)
- M. Moormann
- Department of Pediatric Surgery, Leipzig University, Leipzig, Germany
| | - M. Vollroth
- Department of Cardiac Surgery, Heart Center, Leipzig University, Leipzig, Germany
| | - M. Lacher
- Department of Pediatric Surgery, Leipzig University, Leipzig, Germany
| | - H. Stepan
- Department of Obstetrics, Leipzig University, Leipzig, Germany
| | - D. Gräfe
- Department of Pediatric Radiology, Leipzig University, Leipzig, Germany
| | - U. Thome
- Department of Neonatology, Leipzig University, Leipzig, Germany
| | - S. Rützel
- Department of Neonatology, Leipzig University, Leipzig, Germany
| | - M. Weidenbach
- Department of Pediatric Cardiology, Heart Center, Leipzig University, Leipzig, Germany
| | - I. Martynov
- Department of Pediatric Surgery, Leipzig University, Leipzig, Germany
| | - C. Pügge
- Department of Cardiac Surgery, Heart Center, Leipzig University, Leipzig, Germany
- Department of Neonatology, Leipzig University, Leipzig, Germany
| |
Collapse
|
2
|
Wang G, Xi L, Li H, Wang Y, Wu C, Pan Z, Li Y, Wang Q, Dai J. Experience in the Treatment of Pentalogy of Cantrell with Artificial Materials in a Single Clinical Center. Eur J Pediatr Surg 2022; 32:50-55. [PMID: 34823268 DOI: 10.1055/s-0041-1739421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To summarize experience in the treatment of pentalogy of Cantrell (POC) in our hospital and explore the effect of artificial materials in repairing sternal defects. MATERIALS AND METHODS A retrospective analysis was performed on treatment of five children with POC treated by using the Gore-Tex patch and titanium mesh in the Department of Cardio-Thoracic Surgery, Children's Hospital of Chongqing Medical University, from January 2010 to January 2019. RESULTS The concurrent conditions included double outlet of right ventricle (n = 2), ventricular septal defect (VSD) and atrial septal defect (ASD) (n = 1), VSD and ASD and patent ductus arteriosus (n = 1), and VSD and left ventricular diverticulum (n = 1) in five cases with POC. Color Doppler echocardiography and computed tomography (CT) + three-dimensional (3D) reconstruction of the thorax and abdomen were performed preoperatively. The cardiac malformation was corrected according to color Doppler echocardiography, and a Gore-Tex patch was used to repair the pericardial defect. Titanium mesh was made according to CT 3D reconstruction with a 3D printing mold to repair sternal defects. All patients underwent a one-stage operation, all hearts were eventually repositioned, no deaths occurred after the operation, and follow-up was performed for 6 months to 2 years. The patients recovered well, and the exterior thorax was normal. CONCLUSION The diagnosis of POC is not difficult. The priority of surgical treatment for POC is to obtain satisfactory corrections of cardiac malformation. The repair of the pericardial defect with the Gore-Tex patch and the sternal defect with the titanium mesh can make the heart return to the mediastinum, reduce the pressure on the heart, reduce the surgical trauma, reduce the difficulty of repairing the sternal defect, and optimally restore the exterior thorax.
Collapse
Affiliation(s)
- Gang Wang
- Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Linyun Xi
- Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Hongbo Li
- Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Yi Wang
- Pediatric Intensive Care Unit, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Chun Wu
- Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Zhengxia Pan
- Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Yonggang Li
- Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Quan Wang
- Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Jiangtao Dai
- Department of Cardio-Thoracic Surgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| |
Collapse
|
3
|
Wang D, Zheng B, Zhai B, Mo J, Yang K, Huo Y. Clinical and ultrasound findings of pentalogy of Cantrell in a newborn: A case report. Front Pediatr 2022; 10:998495. [PMID: 36458139 PMCID: PMC9705726 DOI: 10.3389/fped.2022.998495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Pentalogy of Cantrell is a rare and deadly syndrome, manifesting as intracardiac anomalies and ventricular diverticulum. Echocardiographers have an insufficient understanding of pentalogy of Cantrell, which may lead to missed diagnoses, especially in cases lacking the most obvious signs. CASE SUMMARY One of twin male infants, at a gestational age of 37 weeks, was found with a cardiac murmur and a pulsatile mass in the midline supraumbilical abdomen for 2 days. Echocardiography on admission indicated congenital heart disease. A cardiac murmur was detected in the 3-4 intercostal space and extensively spread. The infant was diagnosed with pentalogy of Cantrell by ultrasound and computed tomography angiography (CTA) preoperatively. The patient underwent heart deformity surgery and was followed up for 16 months. The patient's cardiac structure and function returned to normal. CONCLUSION Intracardiac anomaly and ventricular diverticulum are the primary manifestations of pentalogy of Cantrell. Pentalogy of Cantrell may be diagnosed by combining the ultrasound and CTA findings.
Collapse
Affiliation(s)
- Dan Wang
- Department of Ultrasound, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, ZhengZhou China
| | - Bin Zheng
- Department of Radiology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, ZhengZhou China
| | - Bo Zhai
- Department of Cardiothoracic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, ZhengZhou China
| | - Juan Mo
- Department of Ultrasound, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, ZhengZhou China
| | - Kaihua Yang
- Department of Radiology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, ZhengZhou China
| | - Yaling Huo
- Department of Ultrasound, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, ZhengZhou China
| |
Collapse
|
4
|
Abstract
Pentalogy of Cantrell is a constellation of five congenital defects that pose a unique challenge for surgeons. Defects of the heart, pericardium, diaphragm, sternum, and anterior abdominal wall are pathognomonic. Although the incidence is low, it is critical to identify it in a timely fashion in order to adequately address all aspects. Early diagnosis, supportive care, and strategic surgical planning with a multidisciplinary team are all key components in managing patients with Pentalogy of Cantrell. In this text we sought to explore the evolution of both the understanding and treatment for this complex entity and provide current recommendations to today's pediatric caregivers.
Collapse
|