Percutaneous mitral commissurotomy in rheumatic mitral stenosis associated with cor triatriatum

Area of Science:

• Cardiology
• Congenital Heart Disease
• Interventional Cardiology

Background:

• Cor triatriatum is a rare congenital heart anomaly characterized by an accessory membrane dividing the left atrium.
• Rheumatic heart disease remains a significant cause of mitral stenosis globally.
• The coexistence of cor triatriatum and rheumatic mitral stenosis is exceptionally uncommon.

Observation:

• Two patients presented with symptoms of severe mitral stenosis secondary to rheumatic heart disease and coexisting cor triatriatum.
• Detailed echocardiographic and hemodynamic assessments were performed to evaluate the anatomical complexities.
• The presence of the accessory atrial septum posed unique challenges for intervention.

Findings:

• Percutaneous mitral valvuloplasty (PMV) was successfully performed in both patients, achieving significant relief of mitral stenosis.
• The procedure required careful technical modifications to navigate the anatomical obstruction caused by cor triatriatum.
• Successful PMV demonstrates the feasibility of minimally invasive treatment in this rare combined condition.

Implications:

• This case series highlights that percutaneous mitral valvuloplasty is a viable treatment option for patients with combined rheumatic mitral stenosis and cor triatriatum.
• Understanding the specific anatomical challenges is crucial for successful procedural outcomes.
• These findings may encourage consideration of PMV in similar complex cases, potentially avoiding more invasive surgical approaches.