Coexistence of Cor triatriatum sinistrum and a prominent Eustachian valve mimicking a Cor triatriatum dextrum

First Case of Complete Percutaneous Correction of Isolated Divided Atrium (or Cor Triatriatum) Dexter

Divided atrium (or Cor triatriatum) dexter (DAD) is a rare congenital cardiopathy, usually associated with other anomalies; isolated forms are even rarer. We report the case of an 84-year-old woman presenting with isolated DAD complicated by right-left atrial shunt through patent foramen ovale (PFO), revealed by right cardiac failure and severe hypoxemia. Late destabilization was caused by total superior vena cava thrombosis, related to her pacemaker. Given the overall context, complete percutaneous treatment was performed, associating PFO occlusion and stent implantation in the right atrial membrane, providing total regression of symptoms. Thus, percutaneous correction of DAD appears to be safe and effective.

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.

Spectrum of Echocardiographic Abnormalities among 168 Consecutive Referrals to an Urban Private Hospital in South-Western Nigeria

Trans-thoracic echocardiography (TTE) is an important non-invasive cardiac examination that provides structural and functional information. It is useful in the diagnosis of cardiac diseases and often guides the management and follow-up of patients with cardiovascular diseases (CVD). The study aimed to present an audit of the echocardiograms performed in an urban private hospital over a two-year period in order to define the pattern of cardiac diseases in our center. Echocardiogram reports of 168 consecutive patients performed between May 2011 and April 2013 at an organized private sector hospital in Lagos, south-west Nigeria were reviewed. Studies were performed with a Toshiba Nemio XG ultrasound machine. The data obtained were analyzed for mean age, sex, clinical indications, and echocardiographic diagnosis in the study subjects. A total of 168 echocardiography reports were examined, comprising of 92 males (54.8%) and 76 females (45.2%). The age range of the subjects was 10-76 years (mean 42.5 ± 12.1 years). The commonest indication for echocardiography was systemic hypertension and hypertension related causes (38.1%), followed by abnormal resting electrocardiogram (14.9%). Routine annual medical screening was the next most common indication, representing 13.1% of the indications for echocardiography. The other indications are as presented in Table 1. The echocardiogram was normal in 64.3% of the subjects. The commonest abnormality detected was hypertensive heart disease (HHD); accounting for 9.6% of the subjects studied. Isolated atrial enlargement (left, right, or bi-atrial) was the next most common abnormality accounting for 6% of the echocardiographic diagnosis. Pulmonary hypertension was the next most common diagnosis accounting for 4.8% of our findings. The other echocardiographic diagnoses are as listed in Table 2. Hypertension represents the commonest indication for echocardiography. Normal echocardiogram was the commonest echocardiographic finding while HHD was the commonest echocardiographic abnormality. The prevalence of ischemic heart disease by echocardiography was 2.4%. There was no case of rheumatic heart disease (RHD). The prevalence of hypertrophic cardiomyopathy (HCM) was 1.2%. Ease of access to echocardiography may influence the findings in an echocardiographic audit and policy makers should incorporate appropriateness criteria into their guidelines for reimbursement.