Following the initiation of cardiopulmonary bypass the malalignment VSD and additional muscular VSD were closed with a Dacron patch, the right ventricular outflow tract (RVOT) muscles were resected through the pulmonary valve, the ASD closed primarily, and the cor triatriatum
Diagnosis should also be followed by an evaluation for other congenital abnormalities such as atrial and/or ventricular septal defects, cor triatriatum
, coarctation of the aorta, and endocardial cushion defects [7, 13, 14].
Complete persistence of the right sinus valve results in a membrane separating the smooth and trabeculated portions of the right atrium, constituting cor triatriatum dexter.
Cor triatriatum dexter has varying clinical manifestations depending on the degree of partitioning or septation of the right atrium.
Cor triatriatum, pulmonary vein stenosis, atresia of the common pulmonary vein.
A) Two-dimensional transthoracic echocardiography revealing dilated right atrium and ventricle, atrial septal defect and a membrane at the left atrium, B, C) Two-dimensional transesophageal echocardiography confirming cor triatriatum
sinister and atrial septal defect, D) Three-dimensional transesophageal echocardiography revealing a single opening on the fibromuscular membrane.
Of note, the patient had a previous TTE 5 years ago when first immigrating to Canada, which identified a dilated left atrium and the cor triatriatum defect which had a peak gradient of 9 mmHg, which was not that much different than the more current study.
Given the coexistence of AF and cor triatriatum sinister, the decision was made to initiate anticoagulation with heparin with subsequent conversion to warfarin.
Cor triatriatum sinister is a rare condition in which the clinical features on presentation can mimic those of mitral stenosis due to the obstructive properties of the membrane.
The other congenital cardiac anomalies like atrial septal defect, patent foramen ovale and pulmonary venous return anomalies may also accompany the cor triatriatum.
Cor triatriatum sinistrum is a rare congenital cardiac malformation, constituting about 0.1-0.4% of congenital heart disease (1, 2).
Transesophageal echocardiogram (TEE) was performed and the diagnosis cor triatriatum was confirmed.