Totally Endoscopic Robotic Correction of Cor Triatriatum Sinister Coexisting with Atrial Septal Defect

Gao, Changqing; Yang, Ming; Xiao, Chen; Zhang, Huajun; Wang, Gang

doi:10.1097/imi.0000000000000326

Cited by 6 publications

(8 citation statements)

References 6 publications

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“…Additionally, surgical resection of CTS membrane was safe and effective in relieving obstruction without recurrent obstruction during follow‐up. Similar to our findings, prior studies have reported low risk of residual or recurrent obstruction after resection of CTS membrane, a finding that has clinical implications for postsurgical recommendations …”

Section: Discussionsupporting

confidence: 92%

Outcomes in patients with cor triatriatum sinister

Fuchs

Connolly

Said

et al. 2018

Congenital Heart Disease

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Section: Discussionsupporting

confidence: 92%

Outcomes in patients with cor triatriatum sinister

Fuchs

Connolly

Said

et al. 2018

Congenital Heart Disease

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“…A total of 71 (41.5%) patients with CTS required interventional treatment, which was more common among patients with obstructive membrane physiology (86.8% vs 12.6%, p<0.001). The surgical resection of the fibromuscular membrane was done in 65 (91.6%); in 3 (4.2%) patients, percutaneous balloon dilatation of the membrane; in 2 (2.8%) patients, hybrid intervention; and in 1 (1.4%) patient, endoscopic robotic correction 21. Interventional treatment was not required in 78 patients (45.6%), in 12 (7%) were offered, but they refused, and in 5 was not recorded (2.9%).…”

Section: Resultsmentioning

confidence: 99%

“…Whereas CTS in paediatric patients rarely is an incidental finding,29–33 40 this accounts for one of four adult patients with the non-obstructive membrane 15 17 21 47–4929.…”

Section: Discussionmentioning

confidence: 95%

Cor triatriatum sinistrum diagnosed in the adulthood: a systematic review

Rudienė

Hjortshøj

Glaveckaitė

et al. 2019

Heart

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BackgroundWe performed a systematic review of cor triatriatum sinistrum (CTS) diagnosed in adults. The aim of this review was to describe the clinical presentation, natural history and management of this congenital heart disease.MethodsA PubMed literature search for ‘cor triatriatum sinistrum’ published since 2005 was performed. Included patients were divided into those with and without obstructive membrane physiology. The clinical course differences were compared.ResultsA total of 171 published cases were included. The median age at diagnosis was 43 years (IQR, 30–60). Obstructive membrane physiology was observed in 70 (41%), and this patient group was younger at presentation (median age 39 (IQR, 28–52) vs 50 years (IQR, 32–64), p=0.003).Patients with obstructive membrane more frequently had associated cardiac defects (58.6% vs 42.4%, p=0.039). Overall, the most frequent clinical symptom was atrial fibrillation, as this was present in 56 (32.8%) of all patients. CTS-related symptoms were more frequent in patients with obstructive membrane: congestive heart failure (44.3% vs 15.2%, p<0.001), pulmonary hypertension (27.1% vs 6.1%, p<0.001), haemorrhage (8.6% vs 0%, p=0.004) and infections manifestation (8.6% vs 0%, p=0.004).A total of 71 (41.5%) patients with CTS required interventional treatment, mainly within patients with the obstructive membrane (86.8% vs 12.6%, p<0.001).ConclusionThe natural history of CTS most often manifests with symptoms of congestive heart failure. Patients with obstructive membrane most often have associated cardiac defects and higher risk for infections and haemorrhage. The interventional treatment of CTS remains the first choice for obstructive membrane.

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“…On this basis, it proved possible to make an individualized review of 193 investigations 1–193 . These findings were then incorporated, as far as possible, with the results of a systematic review of ...…”

Section: Methodsmentioning

confidence: 99%

“…[126][127][128][129][130] There are now isolated reports appearing of hybrid intervention and endoscopic robotic correction. 145,179 Asymptomatic patients with divided right atrium, and limited or no obstruction, usually do not require any intervention. 133 If the patient is undergoing cardiac surgery for other reasons, the persisting venous valves can be removed as part of the original procedure.…”

Section: Surgical Approach and Managementmentioning

confidence: 99%

Surgical management of divided atrial chambers

Sankhyan

Anderson

Chowdhury

et al. 2021

Journal of Cardiac Surgery

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Background and Aim The morphological variations when one, or both, of the atrial chambers is subdivided, are many and varied. We sought to address clinical presentations, potentially misdiagnosed cases, diagnostic modalities, surgical approaches, and outcomes of this “family” of uncommon lesions. Methods A total of 193 published investigations were synthesized. Diagnostic information was provided by clinical presentation, and multimodality imaging studies. Results Almost three‐quarters of patients with divided atrial chambers present during infancy with severe pulmonary hypertension and cardiac failure. Associated cardiac and extra‐cardiac defects are present in between half and nine‐tenths of cases. Acquired division of the left atrium has been reported after the Fontan operation, orthotopic cardiac transplantation, and complicated aortic valvar infective endocarditis. Surgery under cardiopulmonary bypass remains the definitive treatment. Balloon dilation may be considered in anatomically compatible variants in the setting of cardiac failure and pregnancy as a bridge todefinitive treatment. Overall, mortality has been cited between nil to 29%. Presentation during infancy, associated congenital anomalies, pulmonary hypertension, and surgery in the previous era, have been the reported causes of death. The operative survivors have long‐term favourable outcomes, with near normal cardiac dimensions and low risk of recurrence. While asymptomatic patients with division of the right atrium do not need treatment, surgical resection of the dividing partition under cardiopulmonary bypass is recommended in symptomatic patients with complex anatomy, the spinnaker malformation, or associated cardiac anomalies. Balloon dilation may be considered in uncomplicated patients with less obstructive lesions. Hybrid intervention and endoscopic robotic correction also have been performed. Conclusions Resection of the dividing shelf allows the survivors to regain near normal dimensions with a low risk of recurrence. We submit that an increased appreciation of the anatomic background to division of the atrial chambers will contribute to improved surgical management.

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Totally Endoscopic Robotic Correction of Cor Triatriatum Sinister Coexisting with Atrial Septal Defect

Cited by 6 publications

References 6 publications

Outcomes in patients with cor triatriatum sinister

Outcomes in patients with cor triatriatum sinister

Cor triatriatum sinistrum diagnosed in the adulthood: a systematic review

Surgical management of divided atrial chambers

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