Left Ventricular Outflow Tract Diverticulum Masquerading Ventricular Septal Defect

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A 4-month-old female infant, previously diagnosed with ventricular septal defect (VSD), was referred to our hospital.Physical examination revealed a grade 3 systolic murmur.Echocardiography showed an accessory chamber arising from the left ventricular outflow tract (LVOT) through 5.6 mm neck (Figure 1), which contracted synchronously with the left ventricle (LV).Color doppler imaging showed bidirectional shunt between the accessory chamber and the LV.Another 5.8 mm defect was identified in the accessory chamber with left-to-right shunt flow into the right ventricle (Figure 2).Volume-rendered computed tomographic angiography confirmed a congenital muscular diverticulum originating from the LVOT below the right and non-coronary cusp, with a neck mimicking VSD (Figure 3).Due to the risk of progressive heart failure from the shunt, surgical intervention was performed.The neck of the diverticulum was surgically closed, and the cavity was obliterated under cardiopulmonary bypass (Figure 4).

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