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Dynamic three-dimensional echocardiography in the assessment of cor triatriatum
1Medizinische Klinik I., Charité, Humboldt University, Berlin, Germany.
Insights
Cor triatriatum sinistrum, a rare heart defect, was diagnosed in an adult after atrial septal defect surgery. Dynamic 3-D echocardiography confirmed the accessory membrane was not stenosing, thus surgical correction was not needed.
Area of Science:
- Cardiology
- Medical Imaging
- Congenital Heart Disease
Background:
- Cor triatriatum sinistrum is a rare congenital heart malformation.
- It is infrequently diagnosed in adults, often presenting after other cardiac interventions.
- This case highlights a delayed diagnosis in a 55-year-old male post-atrial septal defect repair.
Observation:
- Transesophageal echocardiography (TEE) diagnosed cor triatriatum sinistrum one year after surgical correction of an atrial septal defect.
- The study compared transthoracic echocardiography (TTE), TEE, and cardiac catheterization against dynamic three-dimensional echocardiography (3-D echo).
- 3-D echo provided a novel, noninvasive method to assess the opening size between the accessory and true left atrium.
Findings:
- Dynamic 3-D echo accurately determined the opening size of the accessory membrane.
- Left heart catheterization confirmed the findings from 3-D echo.
- The accessory membrane was found to be non-stenosing in this patient.
Implications:
- Dynamic 3-D echocardiography is a valuable noninvasive tool for evaluating cor triatriatum sinistrum.
- Accurate assessment of membrane stenosis can prevent unnecessary surgical interventions.
- This case underscores the importance of considering rare cardiac malformations even after previous cardiac surgery.
Abstract:
Classic cor triatriatum sinistrum is a rare cardiac malformation to be found in the adult. One year after surgical correction of an atrial septal defect in a 55-year-old man, cor triatriatum sinistrum was diagnosed by transesophageal echocardiography. We compared transthoracic echocardiography, transesophageal echocardiography, and cardiac catheterization to dynamic three-dimensional echocardiography (3-D echo) which offers a new, noninvasive approach to determine the opening size between the accessory and the true left atrium. The findings by 3-D echo, confirmed by left heart catheterization, showed that the accessory membrane was not stenosing. Surgical correction was therefore not indicated in this patient.