Ventricular diverticulum: a review of the literature.

BACKGROUND

Ventricular diverticulum (VD) is a rare cardiac malformation. The surgical indications for VD remain controversial. This review is designed to determine the demographic characteristics, diagnosis, and surgical indications of this disease.

METHODS

Using PubMed and the Chinese electronic databases CNKI, WANFANG, and VIP, a computerized search was performed of the literature from China published between March 1965 and July 2012. Major risk factors for developing VD complications were confirmed by logistic regression analysis in case-control studies.

RESULTS

Ninety-three articles and 127 VD patients were identified in this literature review. VDs can lead to aortic insufficiency, thrombosis, infective endocarditis, heart failure, diverticular rupture, ventricular arrhythmia, and cerebral embolism. In patients with VD complications, 92.3% were men (OR = 6.43, 95% CI = 1.23-33.53), 84.6% of the patients had a fibrous type VD (OR = 10.54, 95% CI = 2.86-38.85), and 48.0% of the cases were subaortic diverticulum (SD) related (OR = 6.41, 95% CI = 1.17-35.19).

CONCLUSIONS

VD can result in rupture, cerebral embolism, heart failure, ventricular arrhythmia, infective endocarditis, thrombosis and aortic insufficiency. Male gender, fibrous type, and SD are three major independent risk factors for developing VD complications. Surgical resection should be performed in those VD patients with risk factors for major complications.