Background:
Cor-triatriatum sinister is a rare congenital heart defect resulting from the division
of the left atrium by a fibro-muscular membrane. It is usual for patients to present
in infancy and early childhood, although some cases remain undetected until adult
life. As a consequence of trans-membrane flow obstruction, the clinical features often
mimic mitral stenosis. At present, the reasons for late presentation are poorly understood.
Methods:
A complete review of all cases of cor-triatriatum sinister published in the English
literature from 1966 to date as mitral stenosis was performed. Statistical analysis
was carried out to determine associations between measurements reflecting the communicating
membrane fenestration area, the presence of several clinical variables and patient
age at initial presentation.
Results:
Both pulmonary capillary wedge pressure and mean pressure gradient were significantly
higher in younger adults. In addition, the incidence of atrial fibrillation and mitral
regurgitation was found to rise with advancing age.
Conclusions:
Cor-triatriatum sinister remains an uncommon form of congenital heart disease although
it is being diagnosed with increasing frequency in adults due to improvements in diagnostic
imaging. This diagnosis should be considered in all patients presenting with signs
or symptoms of mitral stenosis.
Keywords
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References
- Cor triatriatum sinister presenting in the adult as mitral stenosis.Heart. 2003; 89: e26
- Echocardiographic diagnosis of cor triatriatum sinister in the adult.Heart. 2004; 90: 63
- Initial presentation of cor triatriatum in a 55-year-old woman.Am Heart J. 1992; 124: 788-791
- Preoperative assessment of cor triatriatum in an adult by dynamic three dimensional echocardiography was more informative than transoesophageal echocardiography or magnetic resonance imaging.Br Heart J. 1994; 72: 498-499
- Transoesophageal echocardiography in the diagnosis of cor triatriatum; incremental value of colour Doppler.Eur Heart J. 1992; 13: 418-420
- Transesophageal color flow Doppler evaluation of cor triatriatum in an adult.Am Heart J. 1990; 120: 451-455
- Cor triatriatum: preoperative diagnosis in an adult patient.Am J Cardiol. 1970; 26: 310-314
- Cor triatriatum: preoperative echocardiographic diagnosis in an adult patient.J Nucl Med Allied Sci. 1978; 22: 201-205
- Cor triatriatum in the adult. Complicated by mitral insufficiency and aortic dissection.Am J Cardiol. 1967; 19: 749-754
- Hemoptysis: two unusual causes.Can J Cardiol. 1990; 6: 27-30
- Echocardiographic features of cor triatriatum.Am J Cardiol. 1977; 40: 615-619
- Cor triatriatum in adults: three new cases and a brief review.Tex Heart Inst J. 1999; 26: 206-210
- Cor triatriatum sinister, not mitral stenosis, in an adult with previous Sydenham's chorea: diagnosis and preoperative assessment by cross sectional echocardiography.Br Heart J. 1992; 68: 9-11
- Cor triatriatum: report of a case in a young adult with special reference to the echocardiographic features and etiology of the systolic murmur.Am Heart J. 1977; 94: 217-221
- Two-dimensional, spectral Doppler, and color flow imaging in adults with acquired and congenital cor triatriatum.J Am Soc Echocardiogr. 1991; 4: 177-184
- Cor triatriatum. Diagnosis by echocardiography.Br Heart J. 1974; 36: 835-838
- Intraoperative echocardiographic diagnosis of previously unrecognized cor triatriatum.Ann Thorac Surg. 1992; 54: 562-563
- Cor triatriatum in adults.Am Heart J. 1993; 126: 472-474
- Cor triatriatum. Review of the surgical aspects with a follow-up report on the first patient successfully treated with surgery.Circulation. 1967; 36: 101-107
- Biplane transesophageal echocardiographic diagnosis of cor triatriatum.Chest. 1994; 105: 601-602
- Late discovery of cor triatriatum as a result of unilateral pulmonary venous obstruction.Am Heart J. 1995; 130: 624-627
- Percutaneous balloon dilatation of cor triatriatum sinister.Am Heart J. 1996; 132: 888-891
- Cor triatriatum.Thorax. 1966; 21: 175-183
- Cor triatriatum with mitral regurgitation in a 52-year-old male.Cathet Cardiovasc Diagn. 1979; 5: 75-84
- Cor triatriatum presenting as postcesarean section pulmonary edema.J Cardiothorac Vasc Anesth. 1996; 10: 638-639
- Two-dimensional echocardiographic diagnosis of cor triatriatum.Am J Cardiol. 1987; 59: 484-485
- Cor triatriatum masked by coexisting COPD in an adult.Chest. 1989; 96: 676-678
- Cor triatriatum: study of 20 cases.Am J Cardiol. 1975; 35: 59-66
- Cor triatriatum sinister. The role of radiology in the diagnosis of this rare, but curable anomaly.Clin Radiol. 1970; 21: 287-296
- Cor triatriatum sinistrum. Diagnostic features on cross sectional echocardiography.Br Heart J. 1984; 51: 211-219
- Surgical resection of cor triatriatum in a 74-year-old man. Review of echocardiographic findings with emphasis on Doppler and transesophageal echocardiography.J Am Soc Echocardiogr. 1990; 3: 402-407
- Cor triatriatum in an adult with mitral regurgitation and massive left atrial enlargement.Cardiovasc Intervent Radiol. 1983; 6: 37-40
- Cor triatriatum: a new case asymptomatic until adult life.Acta Cardiol. 1973; 28: 546-553
- Uncommon etiologies of atrial fibrillation.Clin Cardiol. 1996; 19: 513-516
- Diagnosis and surgical correction of cor triatriatum in an adult: combined use of transesophageal echocardiography and catheterization.Catheter Cardiovasc Interv. 2000; 51: 83-86
- Transesophageal two-dimensional echocardiography in the diagnosis of cor triatriatum in the adult.J Am Coll Cardiol. 1983; 2: 1011-1015
- Adult cor triatriatum: preoperative identification and successful correction.Chest. 1973; 64: 373-376
- Myxomatous mitral valve degeneration complicating asymptomatic cor triatriatum.Clin Cardiol. 1989; 12: 48-50
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© 2004 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.
