Multimodality Imaging of a Mass Arising from a Cor Triatriatum Sinister Membrane.

Cor triatriatum sinister is a rare entity characterized by a membrane within the left atrium and posterior to the atrial appendage. This defect may cause obstructive symptoms analogous to mitral stenosis. The authors present a case of an incidentally detected enhancing mass originating from a cor triatriatum sinister membrane, with imaging characteristics most suggestive of myxoma. Keywords: MR Imaging, Cardiac, Left Atrium, Congenital, CT Angiography, Echocardiography Supplemental material is available for this article.

Obstructed Supramitral Inflow: Cor Triatriatum Sinister Presentation in Adulthood.

Cor triatriatum is a rare congenital heart defect that occurs when a fibromuscular membrane divides the atrium into two chambers, which may impair blood flow to the ventricle. When it does, the symptoms usually manifest during infancy or early childhood. In this E-challenge, though, the case of a 40-year-old man is reviewed whose symptoms of shortness of breath progressed over the years and were attributed to the diminished mitral valve inflow due to the restricted cor triatriatum sinister associated with pulmonary hypertension, tachycardia-bradycardia syndrome, and atrial fibrillation. Despite routine preoperative evaluation, intraoperative transesophageal echocardiography was used to more accurately evaluate cor triatriatum sinister's morphology, hemodynamic significance, and associated anomalies.

Evaluation of Pulmonary Hypertension with Exercise Right Heart Catheterization in an Adult Patient with Cor Triatriatum Sinister.

Cor triatriatum sinister (CTS) is a rare adult congenital heart disease. The usual presentation may vary according to the size of the hole in the membrane in the left atrium and the pressure gradient. In addition to acute clinical presentations including acute pulmonary edema and sudden cardiac death, patients may present with chronic findings such as right heart failure due to pulmonary hypertension. The development of pulmonary hypertension is an important indicator of mortality. In cases where non-invasive methods are not sufficient for the diagnosis of pulmonary hypertension, exercise right heart catheterization may also be used. We present a patient with CTS, in whom the final decision was made with the help of an exercise right heart catheterization.

Cor Triatriatum Sinister Associated with Total Anomalous Pulmonary Venous Connection.

Cor triatriatum sinister is rare congenital heart disease. It is defined as the presence of an abnormal septum dividing the left atrium into two chambers, and in some cases may be associated with a total abnormal pulmonary venous connection. Prenatal diagnosis of cor triatriatum sinister may be possible with fetal echocardiography and the diagnosis can be made earlier than postnatal imaging techniques. In the fetal echocardiography performed in our patient, cor triatriatum sinister was present and the main pathology was the flow of right and left pulmonary vein return from the accessory atrium to the right atrium.

The Multilayered Atrium: An Unusual Case of a Life-Threatening Cor Triatriatum With Persistent Levotrial Cardinal Vein in a 2-Month-Old Infant.

Cor triatriatum sinister (CTS) is a rare congenital cardiac malformation. In CTS, a fibromuscular membrane subdivides the left atrium into 2 chambers. The communication between the 2 chambers is through 1 or more orifices in the dividing membrane. We present an interesting case of a 2-month-old infant with obstructed CTS membrane who first presented on account of poor feeding and failure to thrive. Echocardiography showed a persistent levoatrial cardinal vein (LACV) connecting the left atrium and the innominate vein. This allowed the proximal left atrial chamber to decompress its blood volume into the innominate vein and subsequently the superior vena cava. There was minimal prograde blood flow across the Cor triatriatum membrane, so the majority of pulmonary venous blood ultimately returned to the heart by way of the decompressing vertical vein into the systemic venous circulation. Surgical repair was performed with an uneventful postoperative course. The specific anatomical variant of Cor triatriatum found in our subject has rarely been reported.

Hidden problems in a case of atrial fibrillation.

Atrial fibrillation (AF) is the most common cardiac arrhythmia. However, the relation between congenital heart defects and the predisposition to AF is not fully understood. A 65-year-old male was admitted into the emergency department due to progressive dyspnea, orthopnea, palpitations, and edema. Transthoracic echocardiogram showed bi-atrial enlargement and dysplasia of the mitral leaflets with severe mitral regurgitation. Also, a membrane was noted in the LA, dividing the chamber into two parts, suggestive of cor triatriatum sinister. Coronary computed tomography angiography demonstrated a soft tissue septum in the left atrium. Multimodal evaluation is of vital importance for a complete approach, since, detected in time, it has an excellent prognosis.

A rare case on anomalous pulmonary venous drainage in congenital cardiovascular disease.

Anomalous pulmonary veins drain into the right side of the left atrium is an uncommon variety of anomalous pulmonary venous return. Rarely, anomalous pulmonary venous drainage combined with cor triatriatum and atrial septal defect. We presented the imaging findings of a male patient who had anomalous pulmonary venous drainage which has not previously been described.

Do we really need a new classification for cor triatriatum sinister?

Current classifications of cor triatriatum sinister (CTS) do not address the associated heart defects or single ventricle pathology. Therefore, these classifications are not prognostic classifications and only describe the anatomy and the pulmonary venous drainage. The proposed classification considered the associated congenital cardiac lesions and the single ventricle pathology, therefore, it could have prognostic value. Future multicenter studies are required to measure the performance of this classification and its prognostic value in patients with CTS.

Cor Triatriatum Dexter: An Innocent Bystander.

Cor triatriatum dexter is a rare congenital heart defect with a varied clinical presentation ranging from asymptomatic to right heart failure. Accurate diagnosis is imperative as it may affect clinical decision making. We present a multimodality imaging assessment of cor triatriatum dexter in a 70-year-old woman with severe tricuspid regurgitation.

Cor triatriatum dexter of unusual morphology in a miniature schnauzer.

A five-year-nine-month-old, male entire, miniature schnauzer presented for further investigation of pleural effusion. Echocardiography revealed a perforated membrane dividing the right atrium into two chambers: the true right atrium (a small, lower-pressure, cranioventral chamber communicating with the tricuspid valve and right ventricle) and the accessory right atrium (a larger, higher-pressure, caudodorsal chamber), consistent with a cor triatriatum dexter. This was confirmed using computed tomography angiography. Imaging studies revealed that both the cranial and caudal vena cava entered the higher-pressure accessory right atrium and the coronary sinus entered both the accessory and true right atrial chambers. This differed from the more usual canine cor triatriatum dexter presentation with the cranial vena cava entering the lower-pressure cranial chamber and the caudal vena cava entering the higher-pressure caudal chamber. Balloon membranostomy was successful in reducing the pressure gradient between the two right atrial chambers with subsequent resolution of the clinical signs. The patient continues to do well after three-years of follow-up.

Cor triatriatum dexter: a rare incidentaloma.

Cor triatriatum dexter (CTD) is an extremely rare finding resulting from the persistence of the right valve of sinus venosus. It is a congenital cardiac anomaly defined by an abnormal septation of the atrium leading to inflow obstruction to the respective ventricle. Multimodal diagnostic modalities are necessary to characterize it for an optimal patient management. We report the case of a 68-year-old woman who presented to our clinic for further feedback of ventricular ectopic beats.