A Case of Persistent Junctional Reciprocating Tachycardia Coincident With Cor Triatriatum Sinister.

Persistent junctional reciprocating tachycardia is a rare form of refractory atrioventricular reentrant tachycardia that accounts for <1% of supraventricular tachycardia in pediatrics. The accessory pathways are generally isolated with few reported underlying structural heart defects. We present a case of a five-month-old male with refractory tachyarrhythmia found to have cor triatriatum sinister, which to our knowledge, is the first reported case of these two rare anomalies coexisting.

Exploring new frontiers: a rare case of catheter ablation for persistent atrial fibrillation in a patient with cor triatriatum sinister guided by intracardiac echocardiography.

BACKGROUND: Cor triatriatum sinister (CTS) is an uncommon congenital cardiac anomaly. Atrial fibrillation (AF) is commonly the initial symptom in patients with CTS, occurring in approximately 32% of the cases. The complexity of performing AF catheter ablation, particularly in cases with persistent AF, increases in patients with CTS due to its unique structural challenges. CASE PRESENTATION: We report the treatment course of a 60-year-old male patient diagnosed with CTS, who underwent catheter ablation of drug-refractory, persistent AF. The complex anatomical structure of the condition made catheter ablation of AF challenging. To navigate these challenges, we performed comprehensive assessments using transthoracic echocardiography and transesophageal echocardiography, along with cardiac computed tomography angiography, prior to treatment initiation. The intricate anatomy of CTS was further clarified during the procedure via intracardiac echocardiography (ICE). Additionally, the complexity of catheter manipulation was further reduced with the aid of the VIZIGO sheath and the vein of Marshall ethanol infusion to achieve effective mitral isthmus blockage, thereby circumventing the impact of the CTS membrane. CONCLUSIONS: This case underscores the complexity and potential of advanced ablation techniques in managing cardiac arrhythmias associated with unusual cardiac anatomies. During the procedure, ICE facilitated detailed modeling of the left atrium, including the membranous structure and its openings, thus providing a clearer understanding of CTS. It is noteworthy that the membrane within the CTS may serve as a potential substrate for arrhythmias, which warrants further validation through larger sample studies.

Cor triatriatum / Cor triatriatum

Pacietne de 16 anos com insuficiência cardíaca e hipertensäo pulmonar, simulando estenose mitral. ecocardiografia bidimensional mostrou valva mitral normal e imagem linear em átrio esquerdo, confirmada à angiografia que evidenciou membrana de cor triatriatum com orifício de 4 mm. Realizou-se ressecçäo cirúrgica da membrana, com bom resultado

A 16-year-old patient was evaluated for congestive heart failure and pulmonary hypertension, suggesting mitral valve stenosis. A left atrial membrane with a 4 mm orifice was seen in echocardiography and angiography, and a diagnosis of cor triatriatum was made. The membrane was successfully removed by surgery

Cor Triatriatum. Experiencia diagnóstica y quirúrgica / Cor Triatriatum. Diagnostic and therapeutic experiences

Se presentan cinco casos de cor triatriatum correspondientes a sujetos con edad promedio de 3.6 años (límites: 11 meses y 10 años), que fueron manejados durante un periodo de menos de 2 años, y se hace una revisión de la literatura. Tres pacientes fueron operados con resultados satisfactorios, otro enfermo falleció después del cateterismo cardiaco por edema pulmonar agudo y el último, con una obstrucción poco significativa, está en espera del tratamiento quirúrgico. Se hace énfasis en la utilidad del eco Doppler color para establecer el diagnóstico de esta cardiopatía congénita. No tenemos una explicación completa para la frecuencia del tal cardiopatía en un lapso tan corto