DIVERTICULUM OF THE LEFT-VENTRICLE ASSOCIATED WITH SUBVALVAR AORTIC-STENOSIS

Diverticula of the left ventricle are rare and only a few cases have b een documented in adults. They may be asymptomatic or may present with embolization, pain, endocarditis, or sudden death. We report the case of a 34-year-old woman who presented a cardiac arrest with ventricula r fibrillation which required electrical cardioversion. She was found to have a left ventricular diverticulum associated with a subvalvar ao rtic stenosis. The diverticulum arose from the apex with a narrow conn ection to the ventricular cavity. A subvalvar fibrous ridge stenosis w ith a systolic pressure gradient of 115 mmHg was observed. Coronary an giography revealed normal coronary arteries. The diverticulum and the subvalvar fibrous ridge were resected. Histologic examination of the d iverticulum wall demonstrated the presence of the three normal layers with marked muscle cell hypertrophy, atypical plexiform structure and fibrous endocardium. The pathophysioloy of diverticula associated with subvalvar aortic stenosis are discussed.