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Doppler echocardiography in the diagnosis of divided left atrium (cor triatriatum sinister).

A case of congenitally divided left atrium detected on cross-sectional echocardiography is described. Simultaneous Doppler examination helped to diagnose the obstructive nature of the partition within the left atrium by locating a turbulent high velocity (2.2 meters/second) diastolic signal. The diagnosis was confirmed on cardiac catheterization and surgery.

Blood Flow Velocity↗

[Cor triatriatum: of six operated patients report].

Six cases of cortriatriatum operated between January 1990 and April 2004. Their ages ranged from 3 months to 22 years. Associated lesions are present in 4 patients. They consisted mostly of interatrial defects. The echocardiography has been considered the procedure of choice for the diagnosis. Results of surgery were excellent for all patients with a mean follow up of 5 years.

Adolescent↗

Cor triatriatum with single atrium presenting in adulthood.

We present the case of an asymptomatic 21-year-old woman referred because of an abnormal routine electrocardiogram. Transthoracic and transesophageal echocardiography revealed a complete absence of the atrial septum, a common atrium septated posteriorly from the pulmonary venous chamber, a partial atrioventricular canal, a cleft mitral valve and a persistent left superior vena cava draining into an enlarged coronary sinus. These findings were confirmed during surgical correction. Our patient presented with an unusual and fascinating combination of congenital malformations that remained well tolerated and undiscovered into adulthood.

Adult↗

[Study of cor triatriatum. Apropos of 6 cases].

The authors report 6 cases of triatrial heart with various and non-specific manifestations and attribute the difficulty of its clinical identification above all to the frequency of associated lesions, which were present in 5 of the 6 cases reported here. An atrial septal defect and left superior vena cava were each seen twice while a ventricular septal defect, sub-valvular aortic stenosis, mitral insufficiency and transposition of the great vessels were each seen once. It was routine echocardiography which led to the discovery of triatrial heart in each of these 6 cases. The value of this investigation in the positive diagnosis of triatrial heart proved, in these patients, to be greater than that of cardiac catheterisation.

Adolescent↗

[Cor triatriatum: total correction in an infant using normothermic inflow occlusion (author's transl)].

Successful correction of cor triatiatum in a 3-month-old infant is presented. The diagnosis was established preoperatively by separate angiocardiographic visualization of the two left atrial compartments. To our knowledge all successful total corrections were done under cardiopulmonary bypass. In this case, the abnormal diaphragm in the left atrium was resected under normothermic inflow occlusion. We believe that the technically very simple resection of the diaphragm does not necessitate the use of extracorporeal circulation in an infant, provided the diagnosis can be made beyond any doubt before the operation.

Heart Atria↗

Cor triatriatum.

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Adult↗

An unusual type of anomalous pulmonary venous drainage associated with a complex left heart hypoplasia and a variety of divided left atrium ("cor triatriatum").

A previously unreported complex congenital cardiac malformation was noted in which a vestigial left atrium consisted of two completely separate portions, one of which was connected to the pulmonary veins but had no outlet orifice. The pulmonary venous drainage was through an anomalous intrapulmonary vein within the displaced right lung into the inferior caval vein above a deformed diaphragm. The left atrioventricular connexion was absent. Some points of terminology are considered.

Abnormalities, Multiple↗