Triatriatum sinistrum em adulto assintomático: relato de caso / Cor triatriatum sinistrum in an asymptomatic adult: a case report

Cor triatriatum é um anomalia cardíaca congênita rara frequentemente diagnosticada na primeira infância. Este estudo de caso apresenta um adulto com um achado acidental de cor triatriatum sinistrum. Com base na apresentação clínica, o paciente foi tratado de forma conservadora. São apresentados achados de imagens ecocardiográficas de cor triatriatum sinistrum deste paciente juntamente de revisão narrativa da literatura sobre essa doença.(AU)

Cor triatriatum is a rare congenital heart anomaly often diagnosed in early childhood. This case study features an adult with an incidental finding of cor triatriatum sinistrum. Based on the clinical presentation, the patient was treated conservatively. Cor triatriatum sinistrum echocardiographic image findings of this patient are presented along with a narrative review of the literature about this disease. (AU)

Cor triatriatum sinister, una anomalía clásica pero un tanto olvidada: A propósito de un caso / Cor triatriatum sinister, a classic but somewhat forgotten anomaly: Apropos of a case

RESUMEN Un corazón con tres aurículas, que sumaba cinco cámaras en total, fue un hecho que sorprendió a la medicina hace ya más de un siglo. Este raro defecto cardíaco congénito tiene muy baja incidencia, lo cual hace que sea muy poco conocido por las jóvenes generaciones de médicos dedicados a las enfermedades cardiovasculares. El cor triatriatum sinister generalmente se diagnostica en la temprana infancia y es considerado una causa congénita de estenosis mitral. La conducta quirúrgica es de elección para poder liberar el obstáculo al adecuado flujo sanguíneo a través de la aurícula izquierda. Se presenta el caso de un adulto joven con síntomas típicos de estenosis mitral, sin aparentes elementos claves al examen físico y con un ecocardiograma que evidencia esta anomalía, apenas vista y publicada en nuestro medio en pacientes adultos.

ABSTRACT A heart with three atria, totaling five chambers in all, was a fact that surprised medicine more than a century ago. This rare congenital heart defect has a very low incidence, which makes it very little known to the young generations of doctors dedicated to cardiovascular diseases. The cor triatriatum sinister is usually diagnosed in early childhood, and it is considered a congenital cause of mitral stenosis. Surgical approach is the choice to release the obstacle in order to adequate blood flow through the left atrium. We present the case of a young adult with typical symptoms of mitral stenosis, without apparent key elements on the physical examination and that the echocardiogram showed this anomaly, hardly seen and published in our field in adult patients.

Cor triatriatum dexter y comunicación interauricular tipo seno venoso: Una asociación infrecuente / Cor triatriatum dexter and sinus venosus atrial septal defect: An infrequent association

RESUMEN El cor triatriatum es una malformación congénita poco frecuente, con una prevalecia de un 0,1% entre todas las anomalías congénitas cardíacas, donde el corazón queda dividido en tres atrios o aurículas. En el cor triatriatum dexter la aurícula derecha queda dividida, por una membrana fibromuscular, en dos partes, una proximal y otra distal, que se comunican o no entre sí. En la evolución natural de la enfemedad, los pacientes pueden permanecer asintomáticos hasta su diagnóstico o presentar manifectaciones cardiovasculares secundarias a insuficiencia cardíaca derecha y trastornos del ritmo. En el caso particular de aquellos que se encontraran sintomáticos, el tratamiento de elección sería la corrección quirúrgica del defecto y, en ocasiones, la rotura percutánea de la membrana; mientras que en los que se encuentran asintomáticos, el seguimiento y tratamiento oportuno de sus complicaciones parecería la alternativa más viable.

ABSTRACT Cor triatriatum is a rare congenital condition with a 0.1% prevalence among all cardiac congenital anomalies in which the heart is partitioned into three atria. In cor triatriatum dexter the right atrium is divided by a fibromuscular membrane into two parts, a proximal and a distal one, which may or may not communicate with each other. In the natural course of the condition, patients may remain asymptomatic until diagnosis or present with cardiovascular manifestations secondary to right heart failure and rhythm disorders. In the specific case of symptomatic patients, the treatment of choice would be surgical correction of the anomaly and sometimes percutaneous rupture of the membrane; while in asymptomatic patients, timely follow-up and treatment of their complications would seem to be the best alternatives.

Hybrid balloon dilation treatment for cor triatriatum dexter in a small breed puppy

The authors encountered a 4-month-old, female Shiba dog weighing 4.0 kg, who had been exhibiting abdominal distension and increasing ascites for 2 months. She was brought for further examination and treatment with the chief complaints of ascites and dyspnoea during sleep. The dog was diagnosed with ascites caused by cor triatriatum dexter based on the physical and imaging findings. Under general anaesthesia, she was treated with hybrid balloon dilation under transoesophageal echocardiography guidance. Her postoperative recovery was quite rapid and uneventful. This method appears to be a useful, new, and less-invasive treatment option for cor triatriatum dexter.

Cor triatriatum sinester. A propósito de un caso / Cor triatriatum sinester. Apropos of a case

RESUMEN El cor triatriatum es una anomalía congénita rara. Su prevalencia es de un 0,1% entre todos los pacientes con cardiopatías congénitas. La aurícula queda dividida en dos partes por una membrana fibromuscular; una cámara proximal y otra distal que se comunican entre sí por dos o más orificios con distintos grados de obstrucción. Es más frecuente encontrarlo en la aurícula izquierda (cor triatriatum sinester). Se diagnostica generalmente en la infancia o durante la edad adulta, muchas veces de manera fortuita mediante un ecocardiograma de rutina. Las manifestaciones clínicas en esta rara enfermedad dependerán del grado de obstrucción de la membrana en la aurícula, así como de las cardiopatías congénitas asociadas.

ABSTRACT Cor triatriatum is a rare congenital defect, (estimated incidence of 0.1% of all patients with congenital heart diseases). The atrium is divided into two compartments by a fibromuscular membrane; a proximal and a distal chamber that communicate with each other through two or more perforations with varying degrees of obstruction. It is more commonly found in the left atrium (cor triatriatum sinester) and usually diagnosed in childhood or during adulthood, often incidentally by a routine echocardiogram. Clinical symptoms in this rare disease depend on the severity of obstruction of the membrane in the atrium, as well as the associated congenital heart diseases.

Cor Triatriatum sinester / Cor Triatriatum Sinester

ResumenEl cor triatriatum sinester es una anormalidad cardiaca congénita poco frecuente, que constituye del 0,1 al 0,4% de todas las malformaciones cardiacas. Se caracteriza por una división anómala de la aurícula izquierda por una membrana fibromuscular, la cual genera dos cavidades que se comunican por uno o más orificios con distinto grado de obstrucción.Se asocia con otras anomalías cardiacas, principalmente con comunicación interauricular. Se puede presentar en la infancia, cuando suele ser fatal, o más tardíamente en el adulto, como insuficiencia cardiaca, o incluso cursar de forma asintomática, dependiendo del tamaño de los orificios y del gradiente de presión entre las cavidades. En este artículo se presenta el caso de un masculino de 30 años, sin patologías crónicas, quien consulta por disnea de grandes esfuerzos en los últimos 6 meses, a quien se le diagnostica por medio del ecocardiograma transtorácico y transesofágico un cor triatriatum sinister.

AbstractCor Triatriatum Sinister is a rare congenital heart defect, representing 0.1 to 0.4% of all cardiac malformations. This condition is characterized for an abnormal division of the left atrium by a fibromuscular membrane that generates two cavities, which are connected by one or more orifices with different degrees of obstruction. This condition is associated with other cardiac abnormalities mainly related to atrial septal defects. Its presentation in pediatric patients is often lethal, in adults it may appear as heart failure symptoms or as an asymptomatic finding in echocardiography depending on the pressure gradient between cavities. We present a case report of a 30 years old male without chronic conditions, who complained of dyspnea with strenuous physical activity occurring in the last 6 months, who was diagnosed with a cor triatriatum sinister by the use of transthoracic and transesophageal echocardiogram.

Anesthesia and cor triatriatum.

Aims and Objectives: Cor triatriatum sinistrum (CTS) and cor triatriatum dextrum (CTD) are rare congenital anomalies characterized by the presence of a perforated septum which divides the respective atrium into a proximal and distal chamber. This report reviews the perioperative course of patients with uncorrected cor triatriatum (CT) undergoing procedures requiring anesthesia. In addition, we performed a literature search that examines the experience of others regarding the peri‑operative course of patients with CT. Materials and Methods: A computerized search of a medical record database was conducted to identify patients with a clinical diagnosis of uncorrected CTD and CTS undergoing surgical procedures. Descriptive statistics were used. Results: We identified 12 adult patients with asymptomatic CTS (n = 7) and CTD (n = 5) who underwent 23 anesthetics. There were no perioperative complications which could be attributed directly to the anatomy of CT. Conclusions: Our observation and review of the literature suggest that patients with asymptomatic CT typically tolerate anesthesia and surgical procedures well.

Unusual Case of Cor Triatriatum Sinister

No abstract available.

Incidental discovery of an unusual right atrial membrane in an adult patient.

We describe presence of an unusual right atrial membrane in a 30-year old female with end stage renal disease, hypertension and peripheral vascular disease. The patient was scheduled for midline sternotomy and pericardiotomy and removal of a migrated vascular stent in the right pulmonary artery. An intraoperative transesophageal echocardiogram (TEE) revealed an unusual membranous structure with fenestrations that stretched across the right atrium with attachments superiorly at the free wall and inferiorly at the inter-atrial septum. There was no evidence of flow obstruction across the tricuspid valve. Some of the considerations for the likely diagnosis of this structure were a prominent Eustachian valve, persistent Chiari network, aneurysmal inter-atrial septum, an inter-atrial septal cyst or Cor triatriatum dexter (CTD).

A Case of Acute Cerebral Infarction in Adult Cor Triatriatum Sinistrum / 대한내과학회지

Cor triatriatum is a rare congenital malformation of the heart characterized by a fibromuscular membrane dividing the atrium into two distinct chambers. In the majority of cases, it is diagnosed in early childhood, whereas adult cases are extremely rare [1,2]. The hemodynamics of cor triatriatum are similar to those of mitral stenosis, which sometimes cause embolic infarction. We describe an unusual case of cor triatriatum sinistrum in a 48-year-old man who presented with relapsed embolic infarction.

Anesthetic management of non-cardiac surgery with adult onset type of cor triatriatum sinister: A case report / 대한마취과학회지

A 45-year-old woman with cor triatriatum sinister was admitted for laparoscopic resection of an ovarian tumor. Her medical history was benign with the exception of a single episode of syncope one year ago. A 1.5-cm membrane fenestration was found on echocardiography, but there were no other cardiac structural anomalies. General anesthesia was established with etomidate, sevoflurane, and remifentanil; no notable events occurred during the anesthesia. As cor triatriatum shows a clinical picture of mitral stenosis (MS), careful anesthetic management is required.