Cor triatriatum sinister with left anomalous pulmonary venous drainage to innominate vein: what to do with the vertical vein?

Abstract

We treated a surgical case of a 47-day-old male infant diagnosed with an unusual type of cor triatriatum sinister (CTS) with left anomalous pulmonary venous drainage to the innominate vein via a vertical vein. After preoperative hemodynamic assessment of pulmonary venous (PV) return, this patient underwent a resection of the fibromuscular membrane between the accessory and the true left atrial chambers, concomitant with vertical vein banding to facilitate a left PV return through a common pulmonary venous collector (CPVC). Catheterization three months after this surgery revealed no obstruction of the PV return to the mitral orifice as well as good growth of the CPVC as a left PV return pathway. The patient has been doing well on aspirin.

Cor triatriatum sinister, reporte de un caso

“…El CTS se asocia comúnmente con anomalías del retorno venoso en forma de drenaje venoso pulmonar anómalo parcial o total, el paciente tuvo la variante de tres venas pulmonares derechas y dos izquierdas (9) . Los síntomas predominantes fueron disnea, edema de miembros inferiores y palpitaciones, que correspondían a la insuficiencia mitral severa con insuficiencia tricúspidea severa, esta última secundaria a anuloectasia propiciada por la fibrilación auricular a su vez producida por la dilatación del atrio izquierdo por la fisiología obstructiva de la membrana.…”