[A case of an adult triatrial heart, associated with partial abnormal venous return from the left lung]

The authors underline the value of echocardiography in the diagnosis and postoperative management of a case of cor triatrium. The patient was a 22 year old male who presented with dyspnoea of effort (stage III of the NYHA classification) and clinical signs of an infundibulo-pulmonary syndrome with tricuspid regurgitation. Chest X-ray revealed cardiomegaly (CTI = 61%) and filling-in of the aorto-pulmonary window. The electrocardiogram showed left atrial and right ventricular hypertrophy. The echocardiogram, the key to diagnosis, showed an abnormal echogenic structure within the left atrium. Cardiac catheterisation demonstrated pulmonary hypertension and a difference of pressure between the two lungs. The membrane dividing the left atrium and partial anomalous pulmonary venous drainage from the left lung into the superior vena cava were visualised on late stage pulmonary angiography. Surgical excision of the membrane in the left atrium and ligation of the anomalous venous drainage provided a radical cure to all these malformations.