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Outcomes in patients with cor triatriatum sinister
Margaret M Fuchs1, Heidi M Connolly1, Sameh M Said2
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Congenital Heart Disease
|July 24, 2018
Summary
Cor triatriatum sinister (CTS) typically shows stable left atrial obstruction, particularly in isolated cases diagnosed in adulthood. Surgical resection of the CTS membrane is safe and effective, with a low recurrence risk.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Cor triatriatum sinister (CTS) is a rare congenital heart defect characterized by a membrane dividing the left atrium.
- Understanding the natural history and outcomes of CTS is crucial for patient management.
Purpose of the Study:
- To describe the clinical outcomes and natural history of patients diagnosed with cor triatriatum sinister (CTS).
- To evaluate the effectiveness and safety of surgical intervention for CTS.
Main Methods:
- Retrospective review of 57 patients with CTS from 1990 to 2016.
- Analysis of clinical data, operative reports, and multimodality imaging (echocardiogram, MRI, CT, cardiac catheterization).
Main Results:
- Diagnosis was often delayed, with 61% diagnosed in adulthood.
- 47% of patients underwent surgical resection of the CTS membrane, with younger age and associated congenital heart disease (CHD) being predictors for surgery.
- Surgery was associated with one perioperative mortality and no late mortality or recurrence; conservative management also showed stability.
Conclusions:
- CTS generally follows a stable course without progressive obstruction, especially in isolated cases or those diagnosed later in life.
- Surgical membrane resection for symptomatic CTS is safe and effective, offering excellent long-term outcomes with minimal recurrence.
- Multimodality imaging plays a key role in CTS diagnosis and management planning.
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