Usefulness of intraoperative real-time three-dimensional transesophageal echocardiography in preprocedural evaluation of cortriatriatum -a case report-

Abstract

Cortriatriatum is a rare congenital cardiac disorder with fibromuscular band (diaphragm) dividing the left atrium (LA) into the proximal and distal parts. Surgical correction of cortriatriatum requires full preoperative evaluation of the structural anomalies including the LA diaphragm and their pathophysiology. In the present case, a 44 year-old lady diagnosed as cortriatriatum underwent surgical correction. Intraoperative three-dimensional transesophageal echocardiography provided detailed information regarding the shape and extent of the LA diaphragm, which had been partially evaluated by preoperative two-dimensional transthoracic and transesophageal echocardiography, and facilitated the intraoperative patient management and surgical decision making.

Guidelines for Performing a Comprehensive Transesophageal Echocardiographic

“…Cor triatriatum involves the presence of a fibromuscular band that divides the atria into proximal and distal parts. 153,154 An important distinction from a supravalvular mitral ring is the location of the LAA, which is always distal to the membrane in cor triatriatum sinister (Figure 7 and Video 38). The TEE assessment of this lesion begins in the ME 4-Ch view, with the probe slightly retroflexed to prevent compression of a possible hypertensive pulmonary venous chamber.…”