1/41. The diagnosis of cor triatriatum sinistrum in children: a continuing dilemma.cor triatriatum (CT) is a rare congenital cardiac anomaly. The salient clinical, roentgenographic, electrocardiographic, echocardiographic, and hemodynamic findings are presented in two asymptomatic children and one with nonspecific dyspnea on exertion. Two male children had a classical form of cor triatriatum with normal physical and inconsequential roentgenographic and electrocardiographic findings. One of the male patients had surgery for a large atrial septal defect ostium secundum (ASD 2 degrees) and pulmonary hypertension in infancy. The female patient had CT with a communicating accessory chamber to right atrium and a rare patent foramen ovale. Her clinical findings confirmed an atrial level shunt. All patients had excision of the fibromuscular membrane from the right and left atrial transseptal approach with excellent results and with no recurrence during 2 to 4 year follow-up. We report the dilemma encountered in the clinical diagnosis of CT in children and the pivotal role played by echocardiography in the diagnosis of this anomaly.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/41. Repair of cor triatriatum associated with partially unroofed coronary sinus.A young patient with cor triatriatum, secundum atrial septal defect, persistent left superior vena cava, partially unroofed coronary sinus, and moderate tricuspid regurgitation was documented to have both a left-to-right shunt from the common pulmonary venous chamber to the right atrium and a right-to-left shunt from the partially unroofed coronary sinus to the left atrium. Resection of the membrane dividing the left atrium, closure of the atrial septal defect and the partially unroofed coronary sinus with pericardial patches, and a tricuspid annuloplasty resulted in an excellent hemodynamic result.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
3/41. Left atrial calcification in a hemodialysis patient with cor triatriatum.Myocardial calcification is a rare manifestation of abnormal calcium metabolism seen in some patients with chronic renal failure. This report describes the transesophageal echocardiographic and spiral computed tomography (CT) findings in a young hemodialysis female with severe secondary hyperparathyroidism. These findings included calcification of the multiperforated membrane of a cor triatriatum and the wall of the left atrium.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
4/41. diagnosis and surgical correction of cor triatriatum in an adult: combined use of transesophageal echocardiography and catheterization.This is an unusual case of a 37-year-old male whose initial presentation to medical care was for dyspnea. A transthoracic echocardiogram was suspicious for cor triatriatum, which was confirmed by transesophageal echocardiography. Since the resting transmembrane gradient was low, a cardiac catheterization with exercise hemodynamics was performed and demonstrated a marked increase in pulmonary capillary wedge and pulmonary artery pressures. The cor triatriatum was successfully resected at surgery. We have reviewed the English literature and find this to be a unique approach to diagnosis and management.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
5/41. cor triatriatum sinistrum and persistent left superior vena cava: an original association.cor triatriatum sinistrum is a rare congenital heart disease usually diagnosed in symptomatic children. Symptoms depend on the degree of obstruction to pulmonary venous return with pulmonary hypertension and other associated abnormalities. Persistent left superior vena cava is quite a common congenital heart disease (about 0.5% in healthy populations). It should be suspected every time a dilated coronary sinus is detected at the echo examination. Transthoracic and transoesophageal examinations visualize the site and the size of the fibrous membrane as well as the degree of obstruction, and allow the evaluation of pulmonary pressures that are very important clues for prognosis and therapy. This case report describes the clinical signs and the diagnostic ultrasound findings evaluated in comparison with magnetic resonance imaging, a well-defined gold standard in heart disease of this uncommon congenital association.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
6/41. Use of Inoue balloon dilatation method for treatment of cor triatriatum stenosis in a child.An 8-year-old girl was referred for evaluation of a heart murmur and progressive dyspnea with exertion. Transthoracic echocardiogram revealed cor triatriatum with severe stenosis at its orifice. The resting transmembrane CW Doppler velocity was 2.3 m/sec. cardiac catheterization and hemodynamic assessment were performed and demonstrated a marked increase in pulmonary capillary wedge and pulmonary artery pressures. The stenosis was successfully dilated with an Inoue balloon using a transseptal technique. This is the first description of dilation of a cor triatriatum using the Inoue technique. Only one previous case report of balloon dilatation for cor triatriatum sinister has appeared in the English literature using a different technique (double balloon method).- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
7/41. cor triatriatum sinister presenting in the adult as mitral stenosis.cor triatriatum sinister is a rare congenital defect in which the left atrium is divided by a fibromuscular membrane into two distinct chambers. Classically, patients present in infancy although in some cases they remain asymptomatic until adulthood. The clinical features on presentation can mimic those of mitral stenosis due to the obstructive properties of the membrane. cor triatriatum sinister presented in this case in an adult as mitral stenosis. Factors that may be relevant in determining late presentation are also discussed.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
8/41. Obstructed right pulmonary venous drainage and ipsilateral lung hypoplasia.A case of right lung hypoplasia and dyspnea, presented at our institution for cardiac evaluation, is described. Clinical evaluation and instrumental findings of normally connected but completely obstructed right pulmonary venous drainage have led us to diagnose an exceptional variant of subtotal cor triatriatum. Differential diagnosis was mainly carried out between pulmonary venous anomalies and drainage obstructions. Symptom relief was obtained with surgical excision of the atrial dividing membrane.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
9/41. Intraoperative echocardiographic diagnosis of previously unrecognized cor triatriatum.cor triatriatum is a congenital heart defect resulting in abnormal septation of the left atrium by a fibromuscular membrane. echocardiography has improved the preoperative diagnosis of this rare congenital heart defect. We report a case where transesophageal echocardiography proved useful in the intraoperative diagnosis of a previously undetected cor triatriatum.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
10/41. cor triatriatum sinister, not mitral stenosis, in an adult with previous Sydenham's chorea: diagnosis and preoperative assessment by cross sectional echocardiography.In cor triatriatum sinister, one of the rarest congenital cardiac anomalies, a membrane divides the left atrium into a pulmonary venous component above and the vestibule below. The importance of the anomaly lies in the effects of the resultant pulmonary venous obstruction that usually present in the first year of life and can mimic obstructed total anomalous venous drainage or congenital mitral stenosis. A case presented as mitral stenosis in the third decade of life, ten years after a well documented episode of Sydenham's chorea. The diagnosis was made rapidly by transthoracic echocardiography and transoesophageal echocardiography was used for complete assessment. Cardiac catheterisation added nothing to the non-invasive diagnosis or the preoperative assessment. Uncomplicated corrective surgery was undertaken.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
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