[Diagnosis and evaluation of a patient with cor triatriatum using perioperative transesophageal echocardiography]

Area of Science:

• Cardiology
• Congenital Heart Disease
• Cardiac Surgery

Background:

• Cor triatriatum is a rare congenital cardiac anomaly (0.1-0.4% of cases), typically diagnosed in infancy or childhood.
• It involves a fibromuscular membrane dividing the left atrium, often associated with other cardiac anomalies.
• Adult presentation is rare, often presenting with symptoms mimicking other cardiac conditions.

Observation:

• An adult woman with no prior cardiac history presented with acute heart failure.
• Preoperative echocardiography diagnosed severe mitral regurgitation and cor triatriatum.
• Emergency mitral valve surgery was initiated without precise cor triatriatum typing.

Findings:

• Perioperative transesophageal echocardiography (TEE) was crucial for identifying the specific type (Lucas-Schmidt-I A) of cor triatriatum.
• Accurate TEE diagnosis facilitated safe cardiopulmonary bypass establishment and surgical planning.
• The operation proceeded without complications.

Implications:

• This case highlights the importance of perioperative TEE in diagnosing and managing rare congenital heart defects like cor triatriatum in adults.
• Advanced TEE capabilities among anesthesiologists can significantly enhance the safety of complex cardiac surgeries.
• Early and precise diagnosis, even in rare adult presentations, is key to successful surgical outcomes.