Cor Triatriatum Sinister diagnosed in adult life with three dimensional transesophageal echocardiography

Hamdan, Righab; Mirochnik, Nicolas; Celermajer, David S.; Nassar, Pierre; Iserin, Laurence

doi:10.1186/1471-2261-10-54

Cited by 42 publications

(47 citation statements)

References 9 publications

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“…His systemic blood pressure in right radial artery in sitting posture was 180/100 mmHg. Cortriatrium was first time was seen in 1868.It is a congenital anomaly in which the left atrium or right atrium is divided into two chambers by a fold of tissue, a membrane or a fibro muscular band., The upper part of the corresponding atrium receives venous blood, whereas the lower portion is in contact with the atrioventricular valve The membrane that separates the atrium into two parts may be a complete imperforated band or may have one or more holes for blood to pass [11][12][13][14][15][16][17][18][19][20]. Cortriatriatum sinister is a congenital heart defect characterised by a fibro muscular membrane in left atrium.…”

Section: Case Reportmentioning

confidence: 99%

Echocardiographic Finding of Non-Obstructive Fibromuscular Band in Right Atrium

Jv¹

2016

Vasc Med Surg

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Section: Case Reportmentioning

confidence: 99%

Echocardiographic Finding of Non-Obstructive Fibromuscular Band in Right Atrium

Jv¹

2016

Vasc Med Surg

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“…This cardiac anomaly accounts for 0.1% of cases of congenital heart disease. CTS is often associated with other heart's defects (especially septal defects in 70-80% of patients) [3,4]. Rarely, the combination of two defects may stay for a long time without symptoms.…”

Section: Case Reportmentioning

confidence: 99%

An Unusual Cause of Thromboembolism in a 52 Year Old Man

Zuffada¹

2015

JCTCD

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course parallel to the mitral valve that separated the atrium into postero-superior and anterior-inferior halves ( Figure 4). 3D ultrasound revealed a large opening in the infero-posterior side with a regular flow without hemodynamically significant stenosis ( Figure 5). The cine-MRI confirmed the presence of a small leftright jet flow owing to the traction of the inter-atrial septum by the intra-atrial membrane. Due to the huge communication and the absence of symptoms, currently we didn't consider invasive diagnostic tests or surgery intervention for correction of the defects. We decided to put the patient on therapy with low-dose of acetylsalicylic acid and follow him periodically. DiscussionOur report emphasizes some observations about Cor Triatriatum Sinister (CTS). This congenital defect is a condition in which the left atrium is divided into two chambers by a fenestrated fibromuscular septum [1]. CTS are generally diagnosed in pediatric populations, with age at presentation depending on the size of the membrane fenestration and the resulting obstruction to inflow Case ReportA 52-year-old asymptomatic patient was referred to our Centre after performing a pre surgical ECG for nasal septoplasty. The ECG documented isolated negative T wave in aVL and small r wave in the inferior leads (Figure 1). His mother was suffering from hyperhomocysteinemia and he was affected too, so he was treated with folic acid since he was a child. About 20 years before the patient had a previous retinal arterial thrombosis conditioning partial reduction of the visual field. The physical examination was normal. No arrhythmias were discovered during monitoring. A 2D transthoracic echocardiography revealed a slight hypertrophy of a left ventricle with preserved systolic function. Left atrium was not dilated and there was a mobile membrane-like echogenic structure dividing it into two compartments: a proximal one receiving the pulmonary venous flow and a distal one containing left atrial appendage ( Figure 2). The microbubbles test, performed through transesophageal echocardiography, showed small inter-atrial right to left shunt (Figure 3). MRI documented the presence of the membrane withFigure 1: The ECG shows sinus rhythm, normal heart rate and A-V conduction with isolated negative T wave in aVL and small r wave in the inferior leads.

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“…3 Cor triatriatum sinister biva najËeπÊe otkriven u djetinjstvu, no u nekim sluËajevima dijagnoza se postavlja u odrasloj dobi 4,5 , tada najËeπÊe sluËajno 6 . KliniËka slika i patofi- …”

Section: Raspravaunclassified

“…Prema naπem saznanju, sluËaj ove bolesnice predstavlja prvi sluËaj majËinskoga cor triatriatum sinister u trudnoÊi u Hrvatskoj. diagnosed until later 4,5 and then mostly incidentally 6 . The clinical features mimic those of mitral stenosis.…”

Section: Zakljuëakmentioning

confidence: 99%

A case of cor triatriatum sinister during pregnancy.

Biočić¹,

Vincelj²,

Udovičić³

2014

Cardiol Croat.

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2014;9(1-2):71. Cardiologia CROATICA UvodCor triatriatum sinister rijetka je priroena srËana greπka, koja obiËno biva otkrivena u djetinjstvu. Dijagnoza i praÊe-nje cor triatriatum sinister u potpunosti je moguÊe s minimalno invazivnim metodama, kao πto su transtorakalna i transezofagusna 2D te 3D ehokardiografija. Ove metode su stupovi praÊenja ove rijetke priroene srËane greπke, Ëija rijetkost moaee doprinijeti njezinom neprepoznavanju, no kada je ispravno prepoznata i lijeËena, ishod je izvrstan 1 . Donosimo prikaz sluËaja mlade bolesnice kojoj je cor triatriatum sinister otkriven u odrasloj dobi te njegovo praÊenje tijekom trudnoÊe i uspjeπno konzervativno lijeËenje sve do poroda. Prikaz sluËajaTrudnica u dobi od 30 godina s nedavno otkrivenim asimptomatskim cor triatriatum sinister upuÊena je u ustanovu radi kardioloπke reevaulacije. Od djetinjstva je znala za πum na srcu, no sve do nedavno nije bila kardioloπki obraena. Napore je dobro tolerirala. U statusu je na srcu dominirao holosistoliËki πum s punctum maximum nad apeksom te fiksno rascjepljenim drugim srËa-nim tonom bez naglaπenog P2. Laboratorijski nalazi bili su neupadljiv, kao i zapis 12-kanalnog EKG. Transtorakalnom i transezofagusnom 2D te 3D ehokardiografijom prikazana je fibromuskularna membrana lijevog atrija, koja ga dijeli na dvije komore, od kojih proksimalna prima pluÊne vene. Ko-SAAEETAK: Cor triatriatum sinister rijetka je priroena srËana greπka, koja obiËno biva otkrivena u djetinjstvu. Donosimo prikaz sluËaja mlade bolesnice kojoj je cor triatriatum sinister otkriven u odrasloj dobi te njegovo praÊenje tijekom trudnoÊe i uspjeπno konzervativno lijeËenje sve do poroda. Obzirom na sliËnu patofiziologiju odluËili smo se bolesnicu pratiti kao umjereno teπku asimptomatsku mitralnu stenozu. KliniËko praÊenje i redoviti ehokardiografski pregledi zauzimaju pri tome centralno mjesto. Prema naπem saznanju, ovaj sluËaj pacijentice predstavlja prvi sluËaj majËinskoga cor triatriatum sinister u trudnoÊi u Hrvatskoj. KLJU»NE RIJE»I: cor triatriatum sinister, trudnoÊa, ehokardiografija.SUMMARY: Cor triatriatum sinister is a rare congenital cardiac malformation, usually diagnosed in childhood. We describe a case of maternal cor triatriatum diagnosed in adult age and its successful conservative management throughout pregnancy until postpartum. Due to hemodynamic similarities, we decided to treat the cor triatriatum sinister like a moderate asymptomatic functional mitral stenosis in this case. Clinical controls, regular echocardigraphic controls have a central place in the follow up of gravida with congenital cardiac anomalies. To the best of our knowledge, this case is the first case of maternal cor triatriatum sinister in Croatia.

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Cor Triatriatum Sinister diagnosed in adult life with three dimensional transesophageal echocardiography

Cited by 42 publications

References 9 publications

Echocardiographic Finding of Non-Obstructive Fibromuscular Band in Right Atrium

Echocardiographic Finding of Non-Obstructive Fibromuscular Band in Right Atrium

An Unusual Cause of Thromboembolism in a 52 Year Old Man

A case of cor triatriatum sinister during pregnancy.

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