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Cor triatriatum sinister
Alexander Kadner1, Katharina Meszaros2, Christoph Mueller2
1Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland alexander.kadner@insel.ch.
Insights
Cor triatriatum sinister, a rare congenital heart defect, can mimic mitral stenosis. Surgical resection of the dividing membrane successfully restored pulmonary venous flow in a pediatric patient.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Cor triatriatum sinister is a rare congenital cardiac anomaly characterized by a fibromuscular membrane dividing the left atrium.
- It is frequently associated with other complex congenital heart malformations.
- Limited case reports exist, highlighting the rarity and diagnostic challenges.
Observation:
- A 6-year-old boy presented with symptoms suggestive of mitral valve stenosis and congestive heart failure.
- Diagnostic evaluation revealed the presence of cor triatriatum sinister.
- The patient's clinical presentation mimicked severe left-sided obstructive lesions.
Findings:
- Surgical correction was performed using a left atrial approach.
- A fibromuscular membrane separating the pulmonary venous confluence from the mitral valve was completely resected.
- Postoperative echocardiography confirmed unobstructed pulmonary venous flow and successful relief of the obstruction.
Implications:
- This case underscores the importance of considering cor triatriatum sinister in pediatric patients with unexplained heart failure or mitral stenosis-like symptoms.
- Surgical intervention via a left atrial approach is an effective treatment for cor triatriatum sinister.
- Complete resection of the anomalous membrane can lead to excellent long-term outcomes.
Abstract:
The cor triatriatum sinister is an uncommon congenital cardiac anomaly and reports in the literature are limited. It is often associated with other cardiac malformations, such as atrial septal defect, transposition of the great arteries, tetralogy of Fallot or atrioventricular septal defect. We present here a 6-year old boy who was diagnosed with cor triatriatum sinister, initially showing symptoms similar to mitral valve stenosis and congestive heart failure, and who underwent subsequent surgical correction using a left atrial approach. The fibromuscular membrane, separating the pulmonary veins from the mitral valve, was completely resected and postoperative echocardiography showed unobstructed pulmonary venous flow.
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