scholarly journals Cor Triatriatum Sinistrum: A Rarest Aetiology of Cardiac Chamber Thrombi Mimicking Left Atrial Mass

Author(s):  
Osca Imatsu ◽  
Budi Pikir ◽  
Ricardo Adrian Nugraha

Background. Cor triatriatum is a rare congenital cardiac anomaly, represent 0.1% of all congenital cardiac malformations and may be associated with other cardiac diseases in as many as 50% of cases. The natural history of this defect depends on the size of the communicating orifice between the upper and lower atrial chamber. Case Presentation. We reported case of cor triatriatum in a 12 years old girl with chief complaint of shortness of breath, middle chest discomfort and palpitation since 5 days prior admission. The diagnosis was based on clinical features, chest radiography, electrocardiography and transthoracic echocardiography. Chest radiograph showed rounded cardiac apex and double contour appearance. ECG showed sinus rhythm, 75 beat per minute, RAD, CCWR, RVH, RV strain pattern with ST depression and T-wave inversion in II, III, aVF, V1-V5. TTE revealed 2 chambers of left atrium, with restrictive supramitral membrane, dilated right atrium, right ventricle and left atrium, smallish left ventricle, proximal left atrial thrombus (5.96 x 3.44 cm), relative mitral stenosis, severe mitral regurgitation, mild aortic regurgitation and severe tricuspid regurgitation. A diagnosis of cor triatriatum sinister was made. The only treatment is surgical correction. Medical therapy, with ampicillin and heparin, was administered during admission. Conclusion. Cor triatriatum has been reported in a 12-year-old girl. The diagnosis is confirmed by clinical manifestations, chest radiography and echocardiography. The only therapy is surgical correction. From the field of cardiac surgeon, patients are advised to improve their general conditions before underwent surgical procedures.

2020 ◽  
Vol 18 (1) ◽  
pp. 28-30
Author(s):  
Zanda Grīnberga ◽  
Pauls Sīlis ◽  
Elīna Ligere ◽  
Ingūna Lubaua ◽  
Inta Bergmane ◽  
...  

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.


2014 ◽  
Vol 2 (1) ◽  
pp. 38-39
Author(s):  
V Devagourou ◽  
Sambhunath Das ◽  
Kalpna Irpachi

ABSTRACT Right pulmonary artery to left atrial fistula is a rare congenital cardiac anomaly. A 23 years old man visited an ophthalmologist for complains of diplopia and diminished vision with cyanosis. Computerized tomography angiography diagnosed the presence of right pulmonary artery to left atrium fistula. Intraoperative use of transesophageal echocardiography confirmed the diagnosis and guided in real time for the successful ligation of fistula. Transesophageal echocardiography helped to perform the surgery without cardiopulmonary bypass. How to cite this article Das S, Irpachi K, Devagourou V. Transesophageal Echocardiography Guided Ligation of Right Pulmonary Artery to Left Atrial Fistula. J Perioper Echocardiogr 2014;2(1):38-39.


2020 ◽  
Vol 4 (3) ◽  
pp. 1-6
Author(s):  
Richard S Amara ◽  
Rakhee Lalla ◽  
Jean Jeudy ◽  
Susie Nam Hong

Abstract Background Cor triatriatum sinister (CTS) is a rare congenital cardiac anomaly defined by a fibromuscular membrane which bisects the left atrium. Cor triatriatum sinister has been associated with cardioembolic stroke through mechanisms including stagnation of blood flow within the left atrium, an association with atrial fibrillation (AF), and/or an accompanying atrial septal defect (ASD) or patent foramen ovale. We describe a case highlighting the role that CTS may play in cardioembolic stroke, provide high-quality computed tomography angiography and two- and three-dimensional echocardiography of the CTS membrane, and outline management strategies for this uncommon clinical scenario. Case summary A 35-year-old man with no prior medical history presented with acute onset weakness and aphasia. He was found to have an embolic stroke with left M1 and A1 occlusions and received tissue plasminogen activator followed by mechanical thrombectomy with successful recanalization. A thorough stroke workup revealed CTS with an associated ASD as well as potential protein C deficiency. He was managed with indefinite anticoagulation with apixaban. Discussion This is the 13th reported case of CTS associated with stroke. In most previous cases evidence of blood stasis or frank thrombus was associated with the CTS membrane, and/or existing AF was noted. In this case, none of these were identified, particularly highlighting the surreptitious risk of CTS. In addition, the presence of potential protein C deficiency in this case compounded the risk for thromboembolism and factored into multidisciplinary management decisions.


Author(s):  
Việt Tuấn Thái

SHORT REVIEW OF COR TRIATRIATUM IN CHILDREN AT HUE CENTRAL HOSPITAL Cor triatriatum is a rare congenital cardiac anomaly in which the left atrium is divided into two compartments by an abnormal fibromuscular septum with an opening, producing varying degrees of obstruction of pulmonary venous return. During 7 years from 2012 to 2019, we met 5 cases of children with Cor triatriatum. All of them addmited with dyspnea, a loud S2 and a nonspecific systolic murmur. The patients were correctly diagnosed by echocardiography and successfully operated. Keywords: Cor triatriatum, congenital cardiac anomaly


Author(s):  
Alexander Sokolov ◽  
Viktor Varvarenko ◽  
Evgeny Krivoshchekov ◽  
Andrey Smorgon

Retrospective analysis of echocardiograms was performed in 756 children who received endovascular device or surgical ASD closure from 2006 to 2016 in the Cardiac Center in Tomsk Russia. 564 patients had an endovascular closure and 192 had surgical correction. Follow-up duration was from 1 day to 10 years, mean 3.6 yrs for the device group and 4.2 yrs for the surgery group. The control group consisted of 3393 age-matched healthy patients. In patients with endovascular closure of an ASD, 35% had a change in the shape of the left atrium in early follow-up. Changes in the shape of the left atrium at early follow-up were more often observed in the device group and in children of a younger age. The left atrial changes were a decrease in sphericity and an increase in ellipsoidy. Changes in the shape of the left atrium persisted in 22% after transcatheter correction in the long-term. The change in shape of the left atrium after the placement of ASD devices was accompanied by activation of the mechanical function of the atrium and an increase in the filling pressure of the left ventricle. These changes were not accompanied by any disturbance in the contractility and volume of the heart chambers. In the group with surgical correction of ASD, the contractility and volume of the heart chambers did not significantly differ from those in the device closure group


2020 ◽  
Vol 2020 ◽  
Author(s):  
Ketak Nagare

Cor triatriatum sinister is a rare congenital cardiac anomaly in which a fibromuscular membrane divides the left atria into 2 chambers. It is even rarer when present at an adult age. Symptoms and presentation of the patient depend on the size of the opening into the membrane through which 2 chambers of left atrium communicate with each other. Cor triatriatum sinister rarely remains asymptomatic till adulthood. In adults symptoms of Cor triatriatum sinister mimic the symptoms of mitral stenosis. Corrective surgery is the choice of treatment, but when it present as an emergency case especially at an early age, balloon dilatation of the membrane opening is done. Elective balloon dilatation of membrane opening at an early age diagnosed with Cor triatriatum sinister followed by corrective surgery at an adult age can be a safer option compared to direct corrective surgery at an early age.  We present a case of a 25-year-old female who was diagnosed first time at this age as cor triatriatum sinister and treated successfully with corrective surgery.


2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Phoo Pwint Nandar ◽  
Asim Kichloo ◽  
Thein Tun Aung ◽  
Kevin D. Kravitz

Congenital absence of the left atrial appendage is a rare congenital cardiac anomaly which is usually an incidental finding. We present a rare case of congenital absence of the left atrial appendage in a 77-year-old female patient with atrial fibrillation, and we will discuss the role of anticoagulation in the patient with congenital absence of the left atrial appendage based on the scientific data and theoretic background.


Author(s):  
Kazem Rahimi

Mitral stenosis is obstruction to inflow of blood from left atrium to left ventricle at the level of the mitral valve. Non-valvar causes of left ventricular inflow obstruction include left atrial tumours and cor triatriatum.


Author(s):  
Mrinal Patel ◽  
Nikunj Vaidhya ◽  
Kartik Patel ◽  
Megha Sheth ◽  
Amit Mishra

Cor triatriatum dexter (CTD) is a rare congenital cardiac anomaly with a diverse presentation in every age group. We report a case of CTD in a 36-year-old female who presented with palpitations due to giant right atrium (RA), which we managed successfully with surgical excision of the membrane and RA reduction.


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