Divided left atrium with obstruction of pulmonary venous return in the setting of hypoplasia of the left heart

2004 ◽  
Vol 14 (5) ◽  
pp. 553-556 ◽  
Author(s):  
Sara E. Monaco ◽  
Welton M. Gersony ◽  
Harshwardhan M. Thaker
Keyword(s):  
Left Atrium ◽  
Venous Return ◽  
Pulmonary Veins ◽  
Postmortem Examination ◽  
Cor Triatriatum ◽  
Pulmonary Venous Obstruction ◽  
Left Heart ◽  
Venous Obstruction ◽  
Cor Triatriatum Sinister

We describe an infant with hypoplasia of the left heart diagnosed prenatally who, at birth, had signs of severe pulmonary venous obstruction. Echocardiography indicated normally connecting pulmonary veins, and showed a paradoxical right-to-left shunt across a patent oval foramen. Postmortem examination revealed that the obstruction was due to a divided left atrium, or cor triatriatum sinister, with an imperforate muscular diaphragm separating completely the two components of the divided atrium.

scholarly journals Isolated Cor Triatriatum Sinister: A Case Report

2020 ◽  
Vol 18 (1) ◽  
pp. 28-30
Author(s):  
Zanda Grīnberga ◽  
Pauls Sīlis ◽  
Elīna Ligere ◽  
Ingūna Lubaua ◽  
Inta Bergmane ◽  
...  
Keyword(s):  
Left Atrium ◽  
Pulmonary Veins ◽  
Surgical Excision ◽  
Venous Drainage ◽  
Treatment Method ◽  
Cor Triatriatum ◽  
Cardiac Anomaly ◽  
Congenital Cardiac Anomaly ◽  
Cor Triatriatum Sinister ◽  
The Right

SummaryCor triatriatum sinister is a rare congenital cardiac anomaly that has been identified in 0.1% of children with congenital heart disease. It is defined as a fibromuscular membrane that divides the left atrium into two chambers: a superior (proximal) that in most cases receives drainage from the pulmonary veins and an inferior (distal) chamber that communicates with the mitral valve and the left atrium. Cor triatriatum sinister can be an isolated lesion (approximately 25% of cases), but in many cases it is associated with other congenital cardiovascular anomalies, the most common one being – atrial septal defect(3). Symptoms in patients with cor triatriatum sinister are related to obstruction of pulmonary venous drainage, pressure loading of the right side of the heart and congestive cardiac failure. Depending on the severity of the obstruction and presence of associated cardiac anomalies it can be diagnosed at any age. Diagnosis is usually achieved by echocardiography in early infancy. Elective treatment method is surgical excision of the membrane. Here we present a pediatric patient (4 months old) presenting in cardiogenic shock with a successful correction of isolated cor triatriatum sinister. To confirm diagnosis and success of surgical repair, transthoracic and transesophageal echocardiography were used.

ATRESIA OF THE COMMON PULMONARY VEIN

PEDIATRICS ◽  
1962 ◽  
Vol 29 (5) ◽  
pp. 729-739
Author(s):  
Russell V. Lucas ◽  
Bertram F. Woolfrey ◽  
Ray C. Anderson ◽  
Richard G. Lester ◽  
Jesse E. Edwards
Keyword(s):  
Left Atrium ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Early Death ◽  
Pulmonary Venous Obstruction ◽  
Usual Sense ◽  
Venous Obstruction ◽  
Functional Connection ◽  
The Common ◽  
Common Pulmonary Vein

Among the causes of pulmonary venous obstruction is atresia of the common pulmonary vein. This entity is described in three patients. The anatomic abnormality in these patients was the absence of any functional connection between the pulmonary veins and the left atrium, and anomalous pulmonary venous connection in the usual sense was not present. The results of the severe pulmonary venous obstruction imposed by this abnormality are reflected clinically in severe cyanosis, congestive cardiac failure, and early death. Roentgenograms revealed the diffuse reticular pattern in the pulmonary fields associated with pulmonary venous obstruction. Angiocardiographic techniques permit anatomic diagnosis of this cardiac abnormality and allow its differentiation from the other cardiac abnormalities responsible for pulmonary venous obstruction. Because the cul-de-sac-like confluence of the pulmonary veins is of ample size and lies immediately behind the left atrium, surgical relief of this condition seems possible.

A Rare Case of Cardiogenic Shock: Cor Triatriatum With Anomalous Pulmonary Venous Return

2019 ◽  
Vol 10 (5) ◽  
pp. 651-653
Author(s):  
Bosco Moscoso ◽  
Stefano Congiu ◽  
Javier Mayol ◽  
Carin Walter ◽  
José M. Caffarena
Keyword(s):  
Cardiogenic Shock ◽  
Left Atrium ◽  
Clinical Condition ◽  
Rare Case ◽  
Venous Return ◽  
Cor Triatriatum ◽  
Cor Triatriatum Sinister ◽  
Anomalous Pulmonary Venous Return ◽  
Life Threatening ◽  
Rare Malformation

Obstructive total anomalous pulmonary venous return (TAPVR) is a potentially life-threatening clinical condition and a surgical emergency. Left-sided partial anomalous pulmonary venous return (PAPVR) in association with a subdivided left atrium, also known as cor triatriatum sinister (CTS), is a very rare malformation that can mimic obstructive TAPVR. We present a case of a newborn with clinical manifestation of cardiogenic shock caused by CTS and PAPVR.

Operative Correction of Cor Triatriatum Sinister With Systemic Venous Return Anomaly (Inferior Vena Cava?Left Atrium)

2006 ◽  
Vol 21 (6) ◽  
pp. 578-579
Author(s):  
Mustafa Cikirikcioglu ◽  
Tolga Tatar ◽  
Arzu Dönmez Antal ◽  
Eduardo DA Cruz ◽  
Dominique Didier ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Left Atrium ◽  
Inferior Vena ◽  
Venous Return ◽  
Vena Cava ◽  
Cor Triatriatum ◽  
Operative Correction ◽  
Cor Triatriatum Sinister ◽  
Systemic Venous Return ◽  
Return Anomaly

scholarly journals Cor Triatriatum Sinister Identified after New Onset Atrial Fibrillation in an Elderly Man

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ignacio A. Zepeda ◽  
Peter Morcos ◽  
Luis R. Castellanos
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Treatment Options ◽  
Pulmonary Veins ◽  
Cor Triatriatum ◽  
Cardiac Anomaly ◽  
Venous Flow ◽  
Cor Triatriatum Sinister ◽  
Onset Atrial Fibrillation ◽  
New Onset

A 73-year-old man with new onset atrial fibrillation with rapid ventricular response underwent transthoracic echocardiography that revealed an echogenic linear structure along the left atrium, suggestive of cor triatriatum sinister (CTS). CTS was confirmed with transesophageal echocardiography which demonstrated a proximal accessory atrium receiving pulmonary venous flow separated from a distal true atrium by a fibromuscular membrane with a large fenestration allowing flow between the chambers. In CTS, the left atrium is divided into proximal and distal chambers by a fenestrated fibromuscular septum. This cardiac anomaly accounts for 0.1% of cases of congenital heart disease and rarely presents in adults. CTS is primarily diagnosed with echocardiography and is associated with left atrial enlargement and development of atrial fibrillation. Treatment options depend on size of the communication between proximal and distal chambers, the gradient across the membrane, and the position of pulmonary veins. In some instances, surgical resection of the membrane that divides the left atrium is warranted.

scholarly journals Fluid–structure interaction in a fully coupled three-dimensional mitral–atrium–pulmonary model

2021 ◽  
Author(s):  
Liuyang Feng ◽  
Hao Gao ◽  
Nan Qi ◽  
Mark Danton ◽  
Nicholas A. Hill ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Pulmonary Veins ◽  
Three Dimensional ◽  
Left Heart ◽  
Structure Interaction ◽  
Acute Mitral Regurgitation ◽  
Reversal Flow

AbstractThis paper aims to investigate detailed mechanical interactions between the pulmonary haemodynamics and left heart function in pathophysiological situations (e.g. atrial fibrillation and acute mitral regurgitation). This is achieved by developing a complex computational framework for a coupled pulmonary circulation, left atrium and mitral valve model. The left atrium and mitral valve are modelled with physiologically realistic three-dimensional geometries, fibre-reinforced hyperelastic materials and fluid–structure interaction, and the pulmonary vessels are modelled as one-dimensional network ended with structured trees, with specified vessel geometries and wall material properties. This new coupled model reveals some interesting results which could be of diagnostic values. For example, the wave propagation through the pulmonary vasculature can lead to different arrival times for the second systolic flow wave (S2 wave) among the pulmonary veins, forming vortex rings inside the left atrium. In the case of acute mitral regurgitation, the left atrium experiences an increased energy dissipation and pressure elevation. The pulmonary veins can experience increased wave intensities, reversal flow during systole and increased early-diastolic flow wave (D wave), which in turn causes an additional flow wave across the mitral valve (L wave), as well as a reversal flow at the left atrial appendage orifice. In the case of atrial fibrillation, we show that the loss of active contraction is associated with a slower flow inside the left atrial appendage and disappearances of the late-diastole atrial reversal wave (AR wave) and the first systolic wave (S1 wave) in pulmonary veins. The haemodynamic changes along the pulmonary vessel trees on different scales from microscopic vessels to the main pulmonary artery can all be captured in this model. The work promises a potential in quantifying disease progression and medical treatments of various pulmonary diseases such as the pulmonary hypertension due to a left heart dysfunction.

Cor triatriatum sinister with left anomalous pulmonary venous return to innominate vein

2019 ◽  
Vol 29 (3) ◽  
pp. 428-430
Author(s):  
Christoph Jaschinski ◽  
Murat Uzdenov ◽  
Tsvetomir Loukanov
Keyword(s):  
Venous Return ◽  
Signs And Symptoms ◽  
Radical Resection ◽  
Complete Loss ◽  
Cor Triatriatum ◽  
Simultaneous Operation ◽  
Vertical Vein ◽  
Rare Congenital Abnormality ◽  
Cor Triatriatum Sinister ◽  
Anomalous Pulmonary Venous Return

AbstractCor triatriatum sinister is a rare congenital abnormality, with varying signs and symptoms related to the anatomic features and the components of the accompanying cardiac abnormalities. We present a 3-year-old girl who underwent successful simultaneous operation with complete loss of the membrane and ligation of vertical vein by anomalous venous return. The principles for surgical management of cor triatriatum can be summarised as radical resection of the membrane and correction of other intracardiac anomalies.

scholarly journals Pulmonary Vein: Embryology, Anatomy, Function and Disease

2021 ◽  
Author(s):  
Chan I-Ping ◽  
Hsueh Tung
Keyword(s):  
Cardiovascular Diseases ◽  
Left Atrium ◽  
Developmental Process ◽  
Case Reports ◽  
Treatment Options ◽  
Pulmonary Veins ◽  
Fibrous Tissue ◽  
Whole Body ◽  
Cor Triatriatum Sinister ◽  
Anomalous Pulmonary Venous Connection

Four pulmonary veins come from respective lung lobes drain oxygen-rich blood back to the left atrium. Failure of incorporation with the left atrium can lead to a condition, called Cor triatriatum sinister, that the left atrium is separated into two chambers by an abortive fibrous tissue. The venous system of lung and whole body communicate with each other in the earlier time and they will be disconnected in the following developmental process. Total or partial anomalous pulmonary venous connection refers to that there is/are some degree of the communication exists after birth, which can occur in different sites. In the veterinary field, retrospective studies and several case reports have been published to describe these rare congenital cardiovascular diseases in several species. More cases are need for better understanding their clinical manifestation, treatment options and outcomes.

scholarly journals Neonatal repair of total anomalous pulmonary venous connection accompanied by unilateral lung agenesis and Goldenhar syndrome: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takahiro Ito ◽  
Ikuo Hagino ◽  
Mitsuru Aoki ◽  
Kentaro Umezu ◽  
Tomohiro Saito ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Veins ◽  
Median Sternotomy ◽  
Bronchial Tree ◽  
Pulmonary Venous Obstruction ◽  
Goldenhar Syndrome ◽  
Venous Obstruction ◽  
Vertical Vein ◽  
Lung Agenesis ◽  
Anomalous Pulmonary Venous Connection

Abstract Background Total anomalous pulmonary venous connection accompanied by unilateral lung agenesis and Goldenhar syndrome is extremely rare. Case presentation We present a case of total anomalous pulmonary venous connection accompanied by unilateral lung agenesis and Goldenhar syndrome in a patient who was diagnosed based on transthoracic echocardiography and computed tomography. We observed complete absence of the lung, the bronchial tree, and vascular structures on the right side, with abnormal drainage of the left pulmonary veins into the innominate vein. The patient showed clear clinical evidence of pulmonary venous obstruction and underwent surgery 3 days after birth. The pulmonary venous chamber containing the vertical vein was anastomosed to the left atrium using 7–0 PDS running sutures via a median sternotomy. Echocardiography and computed tomography performed 1 year postoperatively revealed no pulmonary venous obstruction. Conclusion We report a rare case of total anomalous pulmonary venous connection accompanied by unilateral lung agenesis and Goldenhar syndrome, which was successfully repaired 3 days after birth. A median sternotomy is a safe and effective approach for surgical repair of congenital heart disease with unilateral lung agenesis. Repair of the supra cardiac total anomalous pulmonary connection using the vertical vein is feasible in patients with a small pulmonary venous chamber.

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