Related Experiment Video
Updated: Feb 25, 2026

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
A Case Report of Cor Triatriatum Sinister (CTS) in an Asymptomatic Adult with Chronic Adhesive Pericarditis
Yuan-Teng Hsu1, Chee-Siong Lee2, Jui-Sheng Hsu1,3
1Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Insights
Cor Triatriatum Sinister (CTS), a rare heart defect, was found in an adult with chronic adhesive pericarditis. This rare combination may worsen atrial dilation and lead to atrial fibrillation, requiring anticoagulation for stroke prevention.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Cor Triatriatum Sinister (CTS) is a rare congenital heart anomaly (0.1%-0.4% of congenital heart diseases).
- While often diagnosed in infancy, some cases of CTS with large fenestrations remain asymptomatic until adulthood.
- This case highlights a unique presentation of adult CTS coexisting with chronic adhesive pericarditis.
Introduction:
Cor Triatriatum Sinister (CTS) is a rare congenital anomaly, accounting for 0.1%- 0.4% of congenital heart diseases. While often diagnosed and treated in infancy, some cases remain asymptomatic until adulthood due to large fenestrations. This report presents a unique case of CTS in an adult coexisting with chronic adhesive pericarditis, which may have contributed to chronic atrial dilatation, a condition not previously documented.
Case Presentation:
A 60-year-old asymptomatic Taiwanese male underwent a routine medical examination. Coronary computed tomography angiography revealed a fenestrated septum dividing the left atrium, consistent with CTS. Virtual endoscopy confirmed two wide fenestrations. Notably, chronic adhesive pericarditis, evidenced by curvilinear calcifications, was diagnosed. This condition likely exacerbated the hemodynamic impact of CTS, contributing to left atrial dilation and atrial fibrillation. Atrial fibrillation was identified, and the patient was treated with an anticoagulant for stroke prevention.
Conclusion:
This is the first reported case of CTS coexisting with chronic adhesive pericarditis. Advanced imaging modalities, including cardiac computed tomography, angiography, and virtual endoscopy, are crucial for diagnosis and anatomical evaluation. Chronic adhesive pericarditis may amplify the effects of CTS, leading to complications, including atrial fibrillation. Anticoagulation is essential for stroke prevention in such cases.
Related Concept Videos
Pericarditis II: Clinical Features and Diagnostic Tests
Pericarditis III: Medical Management
Pericarditis I: Introduction
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Cardiomyopathy III: Hypertrophic Cardiomyopathy

