Cor Triatriatum Sinister in an Adult: Management Guided by Real Time Three‐Dimensional Transesophageal Echocardiography and Stress Echocardiography

Abstract

A 39-year-old female had cor triatriatum (CT) detected as an incidental finding on transthoracic echocardiography performed to evaluate chest pain. By conventional two- and real time three-dimensional transesophageal echocardiography, the CT membrane had a communicating orifice connecting the accessory and main left atrial chambers that measured 1.3 × 0.8 cm. The resting mean transmembrane gradient was 2 mm Hg. The postexercise mean transmembrane gradient and pulmonary artery pressure were 6 and 40 mm Hg. Extrapolating from cutoff values for postexercise gradients and pulmonary pressures in patients with mitral stenosis, we advised deferring surgery and close clinical and echocardiographic follow up.

Cor Triatriatum Sinistrum: Classification and Imaging Modalities

“…In addition, the presence of associated cardiac lesions such as atrial septal defect, anomalous venous return and less frequently bicuspid aortic valve and dilated sinus venosus (17) could be diagnosed offering a comprehensive anatomic and functional evaluation of these infrequent entities, that guides further surgical treatment options (19, 20) . Figures 1, 2 and 3 illustrate a case of CTS, successfully diagnosed with echography.…”

Usefulness of intraoperative real-time three-dimensional transesophageal echocardiography for pre-procedural evaluation of mitral valve cleft: a case report

“…As in the present case, RT 3D TEE is particularly helpful for evaluating cardiac structures located near the aligned TEE probe (perpendicular to the sonographic beam), such as MV and LA [4]; a single "en face" image from RT 3D TEE depicts the true anatomic perspective of the MV apparatus and facilitates an understanding of MR pathology in a much easier and faster manner [5,6]. After making this new diagnosis, MVRep employing PML patching was performed instead of MVR, which was the preoperatively determined surgical plan.…”

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

“…The real-time 3D echocardiography is especially beneficial in evaluating cardiac structures located near to TEE probe with favorable alignment (perpendicular to sonographic beam), such as MV and LA [3]. Even a single "en face" image from real-time 3D TEE would be able to present a true anatomic perspective of objective cardiac structures which had been shown in this case, and understanding of the detailed structures much easier and faster [2,4,5]. Preoperative 3D TTE as well as other imaging modalities, such as Magnetic Resonance Imaging or Computed Tomography scan, might be useful in evaluating full-spectrum of cortriatriatum as a provider of additional 3D information.…”