Extract

We read with great interest the letter to the editor from Marijon and Redheuil1 entitled ‘Non-invasive “tissue characterization approach” for congenital ventricular outpouchings: role of magnetic resonance with delayed contrast enhanced imaging’ with regard to our recent clinical vignette concerning ‘A giant congenital left ventricular diverticulum simulating an aneurysm’.2

The authors draw the attention to very important and useful aspects concerning the diagnosis of congenital left ventricular aneurysms and diverticula.

We definitely agree that ideally, identification of ventricular outpouching anomalies is established by imaging studies, among which magnetic resonance imaging (MRI) is the reference,1,3,4 particularly with regard to the differential diagnosis between aneurysm and diverticula. MRI allows tissue characterization, precisely evaluates morphological and functional features, and clearly differentiates areas of fibrosis. In selected cases, it might also be instrumental for the differentiation of this disorder from right ventricular dysplasia with spreading to the left ventricle due to the good visualization of fatty or fibrous infiltration of the left myocardium.5

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