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Res Rep Gynaecol Obstet 2017 | Volume 1 Issue 4
November 02-03, 2017 | Chicago, USA
Embryology and In vitro Fertilization
World Congress on
A
case of arrhytmogenic right ventricular dysplasia (ARVD)
was discovered during routine echosonography at 24
weeks of gestation. The four-chamber view showed a large
aneurysmatic area extending from below the tricuspid valve
to the insertion of the moderator band; the affected wall
appeared thin and akinetic, with no flow at color Doppler
investigation, and no evidence of cardiovascular failure. The
size of the aneurysmatic area was unchanged at subsequent
controls (25 and 26 weeks of gestation). Arrhythmias
could be ventricular or atrial since the involvement of the
atrium is frequent. The pregnancy ended in spontaneous
abortion at 27 weeks. The histopathologic examination of
the heart showed the presence of adipocytes interspersed
with myocardial fibers, confirming the diagnosis of ARVD.
The zone of highest amount of adipocytes was located
in the mediomural layers confirming where the disease
starts in the embryo. This is logical because anomalies in
desmosomes is the most frequent genetic factor. As the right
ventricle is made of two perpendicular layers it is possible to
suspect that during embryogenesis a shearing effect is taking
place between the two layers especially because qtg that
time the right ventricle was systemically generating strong
biomechanical forces. Subsequently the sub epicardial layers
were affected more severely than the subendocardial layers.
When the subepicardial layers were almost completely
distroyed the disease seemed to start from the epicardium
towards the endocardium. However, some remnants could
be visible in most of the cases if this is observed carefully.
This case remains unique in the literature.
e:
guy.fontaine2@numericable.frEmbryology of arrhytmogenic right ventricular dysplasia (ARVD)
Guy Hugues Fontaine
University Pierre et Marie Curie, Paris, France