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A characteristic continuous wave Doppler signal in cor triatriatum?
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[A contribution to the morphogenesis of cor triatriatum].
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[Cor triatriatum with mitral incompetence--contribution to diagnosis and therapy].
Authors presented difficulties in diagnosis of the cor triatriatum with the mitral incompetence in 34 years old female patient. Diagnosis was based on two-dimensional and doppler echocardiographic examinations and then angiocardiographically proved. Therapy consisted in resection of the fibromuscular intraatrial septum and implantation of the St. Jude mitral prosthetic valve.
Cor triatriatum dexter with imperforate Ebstein's anomaly.
A case of cor triatriatum dexter is described in which the anomalous right atrial partition is identified as the right venous valve; there is an associated anomaly of the right atrioventricular valve which combines features of Ebstein's anomaly, and an atypical, imperforate, tricuspid atresia.
Diagnosis of cor triatriatum by echocardiography.
The echocardiographic findings in a case of cor triatriatum are described. The diagnosis was suggested by a normal anterior mitral valve echo and a dense band of echoes posterior to the aortic root and within the body of the left atrium; it was documented at cardiac catheterization and proved surgically. Echocardiography is an important diagnostic aid in assessing pulmonary venous obstruction in children.
Cor triatriatum: echocardiograhic findings.
The echocardiographic findings in a patient with cor triatriatum are presented. The preoperative echocardiogram demonstrated an unusual structure behind the mitral valve that moved anteriorly during atrial systole. There was also echocardiographic evidence of abnormalities of mitral valve motion, right ventricular and left atrial enlargement, and pulmonary hypertension. Postoperatively, the unusual echo behind the mitral valve had disappeared and the mitral valve appeared more normal. Left atrial and right ventricular dimension had decreased and the pulmonary valve appeared more normal. Fine diastolic mitral valve fluttering, an abnormal echo behind the anterior mitral valve leaflet moving anteriorly with atrial systole, an abnormal pulmonary valve echogram suggesting pulmonary hypertension, and marked right ventricular and left atrial enlargement were the main echocardiographic findings in our patient.
Cor triatriatum, coarctation of the aorta, and ventricular septal defect: a rare, surgically correctable anomaly.
A case of cor triatriatum associated with coarctation of the aorta and ventricular septal defect, successfully treated surgically by a staged approach, is reported. This combination is a very uncommon but potentially correctable cause of congestive heart failure and death in infancy. Early accurate diagnosis aided by an awareness of this combination and prompt surgical correction should yield excellent long-term results.
[Cor triatriatum in the adult. Its diagnosis by Doppler echocardiography].
We present an adult with echocardiographic diagnosis of cor triatriatum. Continuous wave Doppler echocardiography was able to assess correctly the severity of the left ventricular inflow obstruction caused by the intra-atrial membrane. Even though the diagnosis was confirmed by catheterization, the surgical decision was based in noninvasive data. Postoperative Doppler echocardiography proved the disappearance of the intra-atrial obstruction. The anatomical information obtained by echocardiography as well as the assessment of the intra-atrial obstruction by cardiac Doppler seem to be sufficient to make surgical decisions in patients suffering from this disease. Both are also suitable to test the result of the surgical intervention.
Surgical correction of cor triatriatum sinister in a kitten.
A seven-month-old, male domestic shorthair was presented for respiratory distress. Cor triatriatum sinister was diagnosed based on echocardiography. Surgical dilatation and tearing of the anomalous membrane dividing the left atrium resulted in resolution of clinical signs. Intraoperative echocardiography was used to evaluate the adequacy of the repair.
Cor triatriatum dextrum--an unusual variant of triatrial heart.
The present report describes a rare case of triatrial heart, cor triatriatum dextrum in a 31-year-old woman in whom the anomaly was incidentally detected by radionuclide angiocardiography. Subsequent assessment with two-dimensional echocardiography and right heart catheterization confirmed the presence of a membrane subdividing the right atrium into two distinct chambers. To the best of our knowledge, this is the only case in which this cardiac anomaly was demonstrated by radionuclide technique.
[Prostacyclin oral internal therapy for severe pulmonary hypertension after total correction of cor triatriatum with partial anomalous pulmonary venous return; report of a case].
A 37-day-old girl having cor triatriatum with partial anomalous pulmonary venous return was found on emergent admission. Echocardiography and angiography revealed severe pulmonary hypertension with anomalous pulmonary venous return to inominate vein. She still was in respiratory failure after emergent surgical repair because of severe pulmonary hypertension following pulmonary venous obstruction. Prostacyclin is the first Food and Drug Administration (FDA)-approved treatment for advanced primary pulmonary hypertension, which has antithrombotic properties related to its effect on platelets and is a potent vasodilator of both the systemic and pulmonary arteries, and has positive inotropic properties. We started prostacyclin oral internal therapy for her and she recovered from respiratory problems very quickly. Prostacyclin might be effective for pulmonary hypertension before and after surgical repair as primary pulmonary hypertension.
Surgical repair and postoperative course of an infant with infracardiac total anomalous pulmonary venous connection, cor triatriatum sinistrum and transposition of the great arteries.
The combination of a d-transposition of the great arteries, cor triatriatum sinistrum and a total anomalous pulmonary venous connection of the infracardiac type is a very rare condition. Up to now, one surgical repair in an adolescent with transposed great arteries and total anomalous pulmonary venous drainage of the supracardiac type has been reported. In this paper, an infant with the above mentioned cardiovascular malformation is presented. The common pulmonary vein drained into the inferior vena cava and was obstructed. There were arborisation abnormalities in both lungs with mild pulmonary hypertension. The infant has been successfully operated upon at the age of 6 months and a weight of 4.5 kg. The membrane within the left atrium was resected, the common pulmonary vein was anastomosed to the left atrium and a Mustard procedure was performed. During the first 6 postoperative weeks, the infant had problems with adaptation. There was both a transient ballooning of the Mustard patch with significant obstruction of the pulmonary venous drainage and a delayed pulmonary recovery. Two months later, the patch was straightened and the child could be discharged from hospital. After 12 months, the child died from an infection of the airways.
[Cor triatriatum sinistrum in adults (case report)].
A case is presented of cor triatriatum sinistrum , which has been diagnosed in an adult. The findings of invasive and noninvasive studies have resulted in a diagnosis, which can be confirmed by using two-dimensional echocardiography.
An unusual case of cor triatriatum: clinical presentation and the haemodynamics of a rare anomaly.
The case of a 24-year-old woman with cor triatriatum sinister and a persistent left superior vena cava connected to the junction of the left upper pulmonary vein and left atrium is reported. A diagnosis of partial anomalous pulmonary venous return had been made and the patient underwent surgery. Inspection of the left atrium revealed a complex form of left triatrial heart. The general haemodynamics of the malformation are discussed, with particular emphasis on the features accounting for variation in the clinical presentation. This rare anomaly often remains undiagnosed before surgery and should be considered whenever obstruction of pulmonary venous flow above the mitral valve is not explained by pulmonary vein stenosis, mitral or mitral valve-linked abnormalities, atrial tumours or anomalous pulmonary venous drainage with high resistance to flow.
A combination of two simultaneous tachycardias in the right atrium close to the atrio-ventricular node and within the coronary sinus in a post-operative cor triatriatum patient.
A 71-year-old male was referred to another hospital for dizziness. A bradycardia -tachycardia syndrome and Cor triatriatum were detected, and an operation to resect the membrane in the left atrium and implant a pacemaker epicardially was performed. However, no suitable site could be found on either atria and therefore, a single chamber ventricular pacemaker was implanted. In the electrophysiological study performed in our hospital, we could not detect any atrial potentials in either atria, excluding the region close to the His bundle (HB) and within coronary sinus (CS), in spite of extensive catheter mapping. A regular atrial rhythm with a cycle length of 820 ms, which was synchronous with the rate of the QRS complex on the surface ECG, was recorded only at the HB. Meanwhile, the CS catheter recording exhibited regular focal activity with a cycle length of 150 ms, and this focal activity did not conduct to the atrium close to the HB. Furthermore, this activity was dissociated from the ventricular activity recorded from the CS catheter. During an isoproterenol infusion, an atrial tachycardia with a cycle length of 380 ms was recorded only at the HB, and the twelve-lead ECG exhibited a regular tachycardia with the same cycle length as this tachycardia. Meanwhile, the focal activity within the CS persisted without any change in the cycle length. These findings suggested that there was dissociation between the right atrium (RA) and CS. Furthermore, partial atrial standstill was observed in both atria, excluding the RA close to the atrio-ventricular (AV) node and area within the CS. These rare electrophysiological features were considered to play an important role in the genesis of a simultaneous combination of the two tachycardias at their respective sites.
Cor triatriatum dexter with anomalous pulmonary venous drainage and sinus venosus atrial septal defect.
The atypical location of a membrane in a case of cor triatriatum dexter prompted successful repair of accompanying anomalies, with in situ use of the membrane. The anatomy is described with a review of the literature.
Cor triatriatum with unroofed coronary sinus and persistent left superior vena cava associated with atrial tachycardia.
A 2-year-old girl with cor triatriatum with unroofed coronary sinus and persistent left superior vena cava underwent preoperative radiofrequency catheter ablation for atrial tachycardia attack that developed after admission to our hospital. The procedure was not successful. Cryoablation was successfully performed during corrective surgery. Cutting back from the coronary sinus orifice, resection of the fibrous tissue above the mitral valvular orifice, closure of the excised fossa ovalis and coronary sinus orifice with a Gore-Tex patch, and ligation of the persistent left superior vena cava resulted in an excellent hemodynamic outcome. At 2-year follow-up, the patient was free from tachycardia attack.