[en] The case of a 24-year-old woman with cor triatriatum sinister and a persistent left superior vena cava connected to the junction of the left upper pulmonary vein and left atrium is reported. A diagnosis of partial anomalous pulmonary venous return had been made and the patient underwent surgery. Inspection of the left atrium revealed a complex form of left triatrial heart. The general haemodynamics of the malformation are discussed, with particular emphasis on the features accounting for variation in the clinical presentation. This rare anomaly often remains undiagnosed before surgery and should be considered whenever obstruction of pulmonary venous flow above the mitral valve is not explained by pulmonary vein stenosis, mitral or mitral valve-linked abnormalities, atrial tumours or anomalous pulmonary venous drainage with high resistance to flow.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Radermecker, M. A.
Grenade, Thierry ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique
Jalali, H.
Legrand, Victor ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie
de Leval, M. R.
Language :
English
Title :
An Unusual Case of Cor Triatriatum: Clinical Presentation and the Haemodynamics of a Rare Anomaly
Keith JD, Rowe RD, Vlad P. Heart Disease in Infancy and Childhood. 3rd ed. New York: Macmillan, 1978.
Church WS. Congenital malformations of heart: abnormal septum in the left auricle. Transactions of the Pathological Society of London 1968; 19: 188–90.
Fowler JR. Membranous band in the left auricle. Transactions of the Pathological Society of London 1981; 33: 77–94.
Griffith TW. Note on a second example of division of the cavity of the left auricle into two compartments by a fibrous band. J Anat Physiol 1903; 37: 255–7.
Van Praagh R, Corsini I. Cor triatriatum: pathologic anatomy and a consideration of morphogenesis based on 13 post mortem cases and a study of normal development of the pulmonary vein and atrial septum in 83 human embryos. Am Heart J 1969; 78: 379–405.
Gharagozloo F, Bulkey BH, Hucchins GM. A proposed pathogenesis of cor triatriatum: impingement of the left superior vena cava on the developing left atrium. Am Heart J 1977; 94: 618–26.
Marin-Garcia J, Tandon R, Liucas RV Jr, Edwards JE. Cor triatriatum: study of 20 cases. Am J Cardiol 1975; 35: 59–66.
Thilenius OG, Bharati S, Lev M. Subdivided left atrium and expanded concept of cor triatriatum sinister. Am J Cardiol 1976; 37: 743–52.
Lam CR, Green E, Drake E. Diagnosis and surgical correction of 2 types of triatriatal heart. Surgery 1962; 51: 127–37.
Arrants JE, Riopel DA, Catalano PW. Cor triatriatum: preoperative diagnosis and surgical correction in a ten weeks’ infant. Chest 1973; 63: 1027–8.
Richardson JV, Doty DB, Siewers RD, Zuberbuhler JR. Cor triatriatum (divided left atrium). J Thorac Cardiovasc Surg 1981; 81: 232–8.
Arcienegas E, Farooki ZQ, Hakimi M, Perry BL, Green EW. Surgical treatment of cor triatriatum. Ann Thorac Surg 1981; 32: 571–7.
Bloch G, Heurtematte Y, Menu P. Coeur triatrial. Formes anatomiques et traitement chirurgical de 6 cas consecutifs. Arch Fr Pediatr 1988; 45: 461–6.
Oglietti J, Cooley DA, Irquierdo JP. Cor triatriatum: operative results in 25 patients. Ann Thorac Surg 1983; 35: 415–20.