Tetralogy of Fallot with Cor Triatriatum Dexter in an Adult Patient: A Case Report

Abstract

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect with only approximately 3% of uncorrected patients surviving past age 40. In this case report, we present a 48-year-old mentally retarded man suffering from congenital spastic quadriplegia who was diagnosed with a unique combination of symptomatic TOF and cor triatriatum dexter (CTD). Reduced preload because of CTD with spastic quadriplegia that prevented physical exertion is believed to have facilitated this patient's unusually long survival.

Cor triatriatum dexter and coarctation of the aorta – a rare association in a 7-year-old child with type 1 neurofibromatosis

“…Cor triatriatum dexter can occur in isolated forms, but has also been reported in association with other heart anomalies, mainly of the right heart, such as Ebstein’s anomaly, 2 , 3 pulmonary stenosis or atresia, 4 and tetralogy of Fallot 5 . To the best of our knowledge, coexistence of cor triatriatum dexter with a typical left heart lesion like coarctation of the aorta, as seen in our case, has not been reported previously.…”

Anesthesia and cor triatriatum

“…Finally, forth patient was a 48-year-old man with congenital spastic quadriplegia, who had a combination of uncorrected tetralogy of Fallot and CTD. [16] He underwent an emergent appendectomy, which was followed by a prolonged stay in the intensive care unit and ultimately died from heart failure.…”

“…[14,15] In four isolated reports patients had CTD. [11][12][13]16] One patient, a 67-year-old man with non-obstructive CTD, underwent hydrocelectomy uneventfully. [13] Second patient, a 30-year-old woman on hemodialysis had non-obstructive CTD, underwent uneventful pulmonary artery exploration to remove a migrated vascular stent, but she died later from pancreatitis.…”

“…We identified only six publications that describe patients with uncorrected CT undergoing anesthesia. [11][12][13][14][15][16] Two reports described two adult patients with asymptomatic CTS who had uneventful perioperative course. [14,15] In four isolated reports patients had CTD.…”

Cor triatriatum dexter: A rare cause of cyanosis during neonatal period

“…Cor-triatriatum dexter can occur as an isolated cardiac anomaly as in our case or in association with other heart abnormalities. [ 3 4 5 6 ] In cor-triatriatum dexter, most of systemic venous blood is directed to LA through PFO, which explains the central cyanosis associated with this condition. Depending on the degree of flow obstruction at atrial or TV level, cor-triatriatum dexter might lead to right sided heart failure.…”