Cor triatriatum dexter, atrial septal defects, and pulmonary stenosis-a rare association

Cor Triatriatum Dexter Associated with an Ostium Primum Atrial Defect and Left-Sided Opening of the Coronary Sinus in a Stillborn Fetus

Cor triatriatum is a very rare cardiac malformation characterized by the presence of an abnormal interatrial membrane separating either the left or right atrial chamber into two compartments. It can be associated with other cardiac defects and is often symptomatic in childhood. The signs depend on the size and position of the interatrial membrane and other associated malformations. Here we report a case of right-sided cor triatriatum associated with an ostium primum-type interatrial septum defect and left-sided opening of the coronary sinus in a fetus. The cause of intrauterine death was asphyxia due to total placental abruption.

Computed tomography features of cor triatriatum: an institutional review

OBJECTIVES

Cor Triatriatum is a rare anomaly that can either involves the left atrium (Cor Triatriatum Sinister-CTS) or the right atrium (Cor Triatriatum Dexter- CTD). Preoperative identification of this anomaly is important in determining patient treatment course. The objective of this paper is to understand imaging findings, classification and to familiarise the reader with other associated congenital cardiac anomalies that influence patient management.

METHODS

From the hospital electronic health records (EHR) database, we identified 10 patients of Cor Triatriatum out of 974 patients who underwent cardiac CT between 15 July 2014 and 20 March 2020 for congenital heart disease. Medical records and imaging findings were reviewed retrospectively.

RESULTS

Out of 10 patients, nine patients had CTS (90%) and only one patient had CTD (10%). Five out of nine patients (55.5%) had CTS type II and four (44.4%) had CTS type III. The mean of the membrane orifices in CTS type III was 18.5 mm and was 5.78 mm in CTS type II. Pulmonary veins were dilated in all patients of CTS type II (62.5%), two patient of CTS type III (25%) and in only patient with CTD (12.5%). Ostium secundum atrial septal defect was the most common (66%) associated cardiac anomaly, followed by ventricular septal defect (44%).

CONCLUSIONS

CT allows excellent pre-operative evaluation of Cor Triatriatum and associated cardiac anomalies.

ADVANCES IN KNOWLEDGE

CT is excellent in making a diagnosis and classifying Cor Triatriatum and for identification of cardiac anomalies and complications associated with it.

Cor triatriatum dexter: A rare cause of cyanosis during neonatal period

Cor-triatriatum dexter is an extremely rare congenital heart defect in which there is complete persistence of the right valve of embryonic sinus venosus that results in partitioning of the right atrium into a smooth and trabeculated portion. The smooth portion receives venous blood from inferior vena cava, superior vena cava, and coronary sinus while the trabeculated portion contains the right atrial appendage and the opening of tricuspid valve.

We report a 1-week-old child who presented with intermittent episodes of central cyanosis. Echocardiography, established, and bubble contrast study confirmed the diagnosis of an isolated cor-triatriatum dexter. The baby initially underwent an intervention by cardiac catheterization, which was unsuccessful in disrupting the membrane and re-direct the systemic venous flow to the right heart chambers. She subsequently had the cor-triatriatum dexter membrane resected via an uncomplicated open-heart surgery.