Mid-term outcomes of cor triatriatum repair: comparison of biventricular physiology and univentricular physiology

Nagao, Hiroyuki; Tanaka, Toshikatsu

doi:10.1017/s1047951120003595

Cited by 8 publications

(12 citation statements)

References 16 publications

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“…In the severe form of this condition, patients can present with pulmonary edema, pulmonary hypertension, respiratory failure, and cardiogenic shock [ 20 - 22 ]. In addition, most deaths occurred in patients who presented in a critically ill condition combined with complex associated cardiac anomalies [ 5 , 9 ]. In our study, there was 1 early death; this baby was born with HLHS and CTS, representing a high-risk combination, and collapsed immediately after birth, which led us to perform emergent hybrid palliation consisting of excision of the membrane, atrial septectomy, bilateral pulmonary artery banding, and implantation of a ductal stent.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical resection of CTS can effectively eliminate the anatomical barrier in the atrium with a very low risk of recurrence [ 9 , 23 ]. In our study, no early survivors required reoperation or reintervention during follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Resection of the obstructing membrane using cardiopulmonary bypass is the definitive treatment for CTS. It has been reported that the majority of cases of CTS were associated with other congenital cardiac anomalies [ 3 - 6 ], and the surgical outcomes depended upon the complexity of the associated congenital cardiac anomalies [ 7 - 9 ]. However, there is a lack of data regarding the nature and surgical outcomes of CTS due to its rarity.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Outcomes of Cor Triatriatum Sinister: A Single-Center Experience

et al. 2022

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Background We investigated surgical outcomes after the surgical repair of cor triatriatum sinister (CTS). Methods Thirty-two consecutive patients who underwent surgical repair of CTS from 1993 through 2020 were included in this study. The morphological characteristics, clinical features, and surgical outcomes were described and analyzed. Results The median age and body weight at operation were 9 months (interquartile range [IQR], 3–238 months) and 7.5 kg (IQR, 5.8–49.6 kg), respectively. There were 16 males (50%). According to the modified Lucas classification, type IA (classical CTS) was most common (n=20, 62.5%). Atrial septal defect was associated in 22 patients (68.8%) and anomalous pulmonary venous return in 8 patients (25%). Pulmonary hypertension was preoperatively suspected with a high probability in 18 patients (56.3%). There was 1 early death (3.1%) after emergent membrane excision and hybrid palliation in a high-risk hypoplastic left heart syndrome patient. There were no late deaths. The overall survival rate was 96.9% at 15 years post-repair. No early survivors required reoperation during follow-up. Most survivors (31 of 32 patients, 96.9%) were in New York Heart Association functional class I at a median follow-up of 74 months (IQR, 39–195 months). At the latest echocardiography performed at a median of 42 months (IQR, 6–112 months) after repair, no residual lesion was observed except in 1 patient who had moderate pulmonary hypertension (mean pulmonary arterial pressure of 36 mm Hg). Conclusion Surgical repair of cor triatriatum could be performed safely and effectively with an extremely low risk of recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical Outcomes of Cor Triatriatum Sinister: A Single-Center Experience

et al. 2022

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“…With complex cardiac presentations, our surgical outcomes have been comparable with the current literature. 11,12 We had one isolated PAPVC and one PAPVC with sinus venosus ASD. Atrial level communication was present between the LA and RA in seven patients (78%) while only 2 (28%) had AC to RA communication.…”

Section: Discussionmentioning

confidence: 99%

Cor triatriatum sinister: Long‐term surgical outcomes in children and a proposal for a new classification

Mashadi

Narasimhan

Said

2022

Journal of Cardiac Surgery

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Background Cor Triatriatum Sinister (CTS) is a rare congenital anomaly with an estimated incidence of 0.4%, resulting from abnormal left atrial septation. It may present in isolation or in association with other heart defects. High percentage of patients require surgery with low mortality and recurrence rates. CTS has been classified in the past however we aim to describe a case series with more comprehensive and inclusive classification. Methods This was a single‐center retrospective cohort study of 16 children with the diagnosis of CTS between 2000 and 2020. Medical records were reviewed for clinical presentations, hospital, and postoperative courses. Results Sixteen patients (63% female), with a median age at diagnosis of 4.3 months, five (31%) were neonates. Six (38%) had isolated CTS, two (13%) with functional single ventricle (SV), and the remaining eight patients (50%) had other associated heart defects (septal defects in three, coarctation of the aorta in another three, and anomalous pulmonary venous connections in three). Eight patients (50%) presented with obstructed CTS. Twelve patients (75%) underwent surgical intervention. Mortality occurred in three patients (19%) with two surgical (one with total anomalous pulmonary venous connection and another with SV) and one nonsurgical (septal defect with Fanconi anemia). The surgical median follow up was 4.7 years. Recurrence of the membrane occurred in two patients (17%). Conclusions This study showed good long‐term outcomes for patients with isolated and complex CTS. Complete and proper classification of CTS ensures appropriate diagnosis, surgical planning, and better family counseling which may correlate with outcomes.

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“…Additionally, Nagao and colleagues found better survival in CTS patients who had biventricular repair compared to the univentricular pathway (15). Obviously, the univentricular heart was not considered in the previous CTS classifications despite the reported worse outcomes in this category.…”

mentioning

confidence: 99%

Do we really need a new classification for cor triatriatum sinister?

Alaloola¹,

Alghamdi²,

Arafat

2022

Preprint

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Current classifications of Cor Triatriatum Sinister (CTS) do not address the associated heart defects or single ventricle pathology. Therefore, these classifications are not prognostic classifications and only describe the anatomy and the pulmonary venous drainage. The proposed classification considered the associated congenital cardiac lesions and the single ventricle pathology, therefore, it could have prognostic value. Future multicenter studies are required to measure the performance of this classification and its prognostic value in patients with CTS.

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Mid-term outcomes of cor triatriatum repair: comparison of biventricular physiology and univentricular physiology

Cited by 8 publications

References 16 publications

Surgical Outcomes of Cor Triatriatum Sinister: A Single-Center Experience

Surgical Outcomes of Cor Triatriatum Sinister: A Single-Center Experience

Cor triatriatum sinister: Long‐term surgical outcomes in children and a proposal for a new classification

Do we really need a new classification for cor triatriatum sinister?

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