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Kilkenny K, Frishman W. Cor Triatriatum: A Review. Cardiol Rev 2023:00045415-990000000-00175. [PMID: 37966218 DOI: 10.1097/crd.0000000000000626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Cor triatriatum is a rare congenital cardiac anomaly, characterized by a fibromuscular partition dividing the left (cor triatriatum sinister) or, rarely, the right atrium (cor triatriatum dexter). Occurring in 0.1-0.4% of congenital heart disease cases, it exhibits diverse clinical presentations, often mimicking mitral stenosis and left-sided heart failure, while occasionally remaining asymptomatic into adulthood. The embryological origin of cor triatriatum remains controversial. Recent years have seen the emergence of new classification systems that offer enhanced prognostic insights. Transthoracic echocardiography is the diagnostic cornerstone. Surgical resection, preferably under cardiopulmonary bypass, is the mainstay treatment, and is associated with favorable long-term outcomes.
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Affiliation(s)
| | - William Frishman
- From the School of Medicine, New York Medical College, Valhalla, NY
- Department of Medicine, Westchester Medical Center, Valhalla, NY
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Barbieri F, Schröder M, Beyhoff N, Landmesser U, Reinthaler M, Kasner M. Percutaneous Edge-to-Edge Tricuspid Valve Repair in a Patient with Cor Triatriatum Dexter: A Case Report. J Cardiovasc Dev Dis 2021; 8:jcdd8090111. [PMID: 34564129 PMCID: PMC8467593 DOI: 10.3390/jcdd8090111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/27/2021] [Accepted: 09/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Tricuspid regurgitation is gaining importance due to its high morbidity and mortality. Especially in the elderly, novel technologies in percutaneous therapies have become valuable options due to the commonly present high surgical risk. Case presentation: We report a case of a 78-year-old female suffering from massive tricuspid regurgitation with repetitive right-sided heart failure hospitalizations. As the patient was very frail and deemed as high surgical risk, we used the TriClip® system to improve her symptomatic status. During diagnostic work-up, an additional membrane separating the right atrium, consistent with the definition of a cor triatriatum dexter, was found. Although increasing the complexity of the procedure, implantation of 3 clips with reduction of tricuspid regurgitation to a mild-to-moderate degree was achieved without any notable complications. The patient was discharged with ameliorated symptoms on the fourth postoperative day. Conclusions: Our case highlights the feasibility of percutaneous edge-to-edge tricuspid valve repair in an elderly woman with cor triatriatum dexter. Accurate echocardiographic visualization is an absolute requirement to gain access to the tricuspid valve without interacting with prevailing additional membranes.
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Affiliation(s)
- Fabian Barbieri
- Department of Cardiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, 12203 Berlin, Germany; (N.B.); (U.L.); (M.R.); (M.K.)
- Correspondence:
| | - Mark Schröder
- Institute of Active Polymers and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Hereon, 14513 Teltow, Germany;
| | - Niklas Beyhoff
- Department of Cardiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, 12203 Berlin, Germany; (N.B.); (U.L.); (M.R.); (M.K.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
- Berlin Institute of Health (BIH), 10178 Berlin, Germany
| | - Ulf Landmesser
- Department of Cardiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, 12203 Berlin, Germany; (N.B.); (U.L.); (M.R.); (M.K.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
- Berlin Institute of Health (BIH), 10178 Berlin, Germany
| | - Markus Reinthaler
- Department of Cardiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, 12203 Berlin, Germany; (N.B.); (U.L.); (M.R.); (M.K.)
- Institute of Active Polymers and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Hereon, 14513 Teltow, Germany;
| | - Mario Kasner
- Department of Cardiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, 12203 Berlin, Germany; (N.B.); (U.L.); (M.R.); (M.K.)
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