VP16.05: Congenital left ventricular aneurysm associated with fetal arrhythmia: evaluation with advanced echocardiographic modalities

Congenital ventricular aneurysms are rare but potentially lethal cardiac anomalies with poorly described etiology and natural course. We report a case of left ventricular (LV) aneurysm associated with ventricular extrasystoles. A 33-year-old healthy patient, gravida 0, was referred at 29 weeks. The echocardiography revealed an aneurysm (size 18 x 20mm) located in the lower posterior free wall of the LV with a wide communication with the ventricle and a thin and hypokinetic wall compromising a third of the total ventricular size, cardiomegaly and sustained ventricular extrasystoles in bigeminism. Additional alterations were excluded. Repeated echocardiographies demonstrated a progressive increase in the cardiomegaly and size of the aneurysm (figure 1a, 26x26mm). The estimated volume of the aneurysm in relation of the rest of the LV by spatio-temporal image correlation (STIC) methodology was 10.6/15.2cm3 (figure 1b). Speckle-tracking analysis using HQ software revealed a global LV strain of -17.43% which was clearly reduced in segments 17–19 (figure 1c), confirming the passive movement of the aneurysm wall. A Caesarean section was performed at 36.6 weeks due to abnormal flow in the ductus venosus. Postnatal echocardiography confirmed the findings. Sinus rhythm was achieved with amiodarone after two episodes of monomorphic ventricular tachycardia. At 2-month follow up, the infant has remained asymptomatic with good biventricular systolic function and sinus rhythm. The optimal management of congenital aneurysms remains unclear. The use of STIC and 2D speckle-tracking techniques allowed us to determine the total aneurysm volume and its functional characteristics to do better counselling. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.