Two-dimensional, Spectral Doppler, and Color Flow Imaging in Adults With Acquired and Congenital Cor Triatriatum

Fagan, Leonard F.; Penick, Danny; Williams, George A.; Labovitz, Arthur J.; Pearson, Anthony C.

doi:10.1016/s0894-7317(14)80529-4

Cited by 15 publications

(12 citation statements)

References 14 publications

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“…Therefore, the obstruction is thought to be severe in early-onset cases, and mild in late-onset cases. Table 1 shows adult patients with mitral regurgitation and cor triatriatum reported in the literature [4][5][6][7][8][9][10][11][12][13][14][15][16]. Almost all reported cases were Lucas-Schmidt IA type of Cor triatriatum, which has no atrial septal defect, and three were IB type, which has atrial septal defect between the accessary chamber and the right atrium.…”

Section: Discussionmentioning

confidence: 99%

Surgical repair of severe mitral valve regurgitation complicated by incomplete cor triatriatum

Umemura

Ohata

Watabe

et al. 2014

Journal of Cardiology Cases

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A 69-year-old woman with exertional dyspnea was referred emergently to our hospital for further evaluation. Transthoracic echocardiography showed severe mitral valve regurgitation and moderate tricuspid regurgitation, which were thought to be the main cause of her heart failure. An electrocardiogram showed paroxysmal atrial fibrillation. Mitral and tricuspid repair and pulmonary vein isolation were scheduled. Intraoperative transesophageal echocardiography revealed a fibromuscular diaphragm and multiple ostia in the left atrium, strongly suggesting cor triatriatum. After left atriotomy, an incomplete transverse membrane was identified in the chamber. The membrane was resected and the mitral valve was repaired; then a tricuspid annuloplasty was performed, and the pulmonary veins were isolated bilaterally. Her postoperative course was uneventful. Cor triatriatum is a rare congenital anomaly, and in some cases is associated with mitral regurgitation. In patients with severe mitral regurgitation, we recommend preoperative transesophageal echocardiography to obtain a correct diagnosis. We should evaluate carefully moderate to severe mitral regurgitation without pulmonary hypertension or left atrial dilatation taking cor triatriatum into consideration.

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Section: Discussionmentioning

confidence: 99%

Surgical repair of severe mitral valve regurgitation complicated by incomplete cor triatriatum

Umemura

Ohata

Watabe

et al. 2014

Journal of Cardiology Cases

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“…Diagnosis of cor triatriatum sinister is usually easily made by transthorathic 2-dimensional/ Doppler echocardiography in pediatric and adult patients. 4,5 Demonstration of LA membrane, which divides the cavity into 2 compartments with the atrial appendage opening into the distal compartment above the mitral valve and the pulmonary veins connected to the proximal compartment, is the main diagnostic feature. Doppler interrogation then assesses the degree of pulmonary venous obstruction across the LA membrane.…”

Section: Discussionmentioning

confidence: 99%

Cor Triatriatum Sinister with and without Left Ventricular Inflow Obstruction: Visualization of the Entire Supravalvular Membrane by Real-time Three-dimensional Echocardiography. Impact on Clinical Management of Individual Patient

Mercer‐Rosa

Fedec

Gruber

et al. 2006

Congenital Heart Disease

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We present 4 cases of cor triatriatum in whom the diagnosis was correctly made by 2-dimensional transthoracic echocardiography, which showed the supravalvular left atrial membrane that divides the left atrium into 2 chambers. The pulmonary veins were connected normally to the proximal left atrial chamber and the left atrial appendage was connected to the distal left atrial chamber. In 1 patient there was evidence of severe pulmonary venous obstruction to the mitral valve by Doppler examination, while in the other three, there was no venous obstruction. Patients were then examined by real-time 3-dimensional echocardiography (RT3DE, using x4 matrix array transducer connected to Sonos 7500 echocardiographic system Phillips, Andover, Mass, USA). This showed the exact morphology of the membrane and led to cancellation of planed surgical intervention in 1 case in which the membrane was only a broad band crossing the left atrial cavity. In addition to delineating the exact morphology of the intracavitary anomaly, this novel echocardiographic imaging modality should be an additive tool to better understand the natural history of these nonobstructive left atrial membranes via longitudinal follow-up of these patients.

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“…This phenomenon is a consequence of surgical technique with creation of a prominent atrial anastomosis, which was called the "snowman" configuration by Stevenson and associates [5]. A prominent suture line also was observed by Fagan and associates [6] near the mitral annulus in the left atrium after orthotopic heart transplantation, with diastolic fluttering of both mitral leaflets suggesting high-velocity diastolic flow. It was attributed by them to the inversion and protrusion of the redundant native and donor atrial tissue into the common left atrium.…”

Section: Commentmentioning

confidence: 91%

Mechanical flow obstruction after heart transplantation diagnosed by TEE

Canivet

Defraigne

Demoulin³

et al. 1994

The Annals of Thoracic Surgery

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We report a case of mechanical flow obstruction after heart transplantation caused by a prominent left atrium suture with a "pursestring" effect. The diagnosis was achieved by transesophageal echocardiography. The mean transstenotic gradient was measured at 13 mm Hg. Because of the profound hemodynamic and multisystemic failure, no surgical correction was attempted. The postmortem examination confirmed the stenosis at the level of the left atrium.

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Two-dimensional, Spectral Doppler, and Color Flow Imaging in Adults With Acquired and Congenital Cor Triatriatum

Cited by 15 publications

References 14 publications

Surgical repair of severe mitral valve regurgitation complicated by incomplete cor triatriatum

Surgical repair of severe mitral valve regurgitation complicated by incomplete cor triatriatum

Cor Triatriatum Sinister with and without Left Ventricular Inflow Obstruction: Visualization of the Entire Supravalvular Membrane by Real-time Three-dimensional Echocardiography. Impact on Clinical Management of Individual Patient

Mechanical flow obstruction after heart transplantation diagnosed by TEE

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