Interventricular septal diverticulum and rheumatic mitral valve disease identified and managed concurrently in middle age
- Resource Type
- Authors
- Gary Zealand; Miles Williams; Joseph Barker
- Source
- BMJ Case Rep
- Subject
- Heart Septal Defects, Ventricular
Male
medicine.medical_specialty
medicine.medical_treatment
Regurgitation (circulation)
030204 cardiovascular system & hematology
digestive system
Sudden cardiac death
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Rare Disease
Internal medicine
Mitral valve
Atrial Fibrillation
otorhinolaryngologic diseases
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Cardiac Surgical Procedures
Pathological
business.industry
Rheumatic Heart Disease
Mitral valve replacement
Mitral Valve Insufficiency
General Medicine
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Echocardiography, Doppler
Tricuspid Valve Insufficiency
digestive system diseases
Middle age
Diverticulum
medicine.anatomical_structure
Cardiothoracic surgery
cardiovascular system
Cardiology
business
- Language
- ISSN
- 1757-790X
Cardiac diverticula represent an extremely rare but serious cause of cardiac morbidity and mortality. They can result to arrhythmia, sudden cardiac death and ventricular dysfunction but may have no pathological implications. Here is a case of a 60-year-old Maori farmer with both rheumatic mitral valve disease and left ventricular (LV) septal diverticulum. The requirement for mitral valve replacement raised the complex decision of whether to undergo concurrent diverticulum repair. The haemodynamic significance of the diverticulum was impossible to ascertain, although we could not in good conscience leave such a large diverticulum with potential to influence further systolic deterioration. Three months after the procedures, the patient developed severe tricuspid regurgitation which is a first reported association postseptal diverticulum repair. The case highlights that careful consideration is required in repairing LV septal diverticula and an emphasis should be placed on complications and the requirement for repeat surgery during the consent process.