A rare case of partial cor triatriatum diagnosed at an adult age: a case report

Author:

von Bartheld Bob1ORCID,Rijnierse Mischa2,van Loon Ramon2,Meijboom Lilian3

Affiliation:

1. Department of Cardiology, St Jansdal Hospital , Wethouder Jansenlaan 90, P.O. Box 138, Harderwijk 3840 AC , The Netherlands

2. Department of Cardiology, Amsterdam University Medical Center , PO Box 7057, Amsterdam, 1081 HV , The Netherlands

3. Department of Radiology and Nuclear Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam , PO Box 7057, Amsterdam, 1081 HV , The Netherlands

Abstract

AbstractBackgroundCor triatriatum sinistra (CTS) is a rare condition where the left atrium (LA) is divided by a thin membrane into an upper and lower chamber. Incidentally, the diagnosis is made in late adulthood, usually because of a favourable variant such as in our patient who presented with partial CTS.Case summaryWe present the case of a 62-year-old female who presented with COVID-19. She was known for longstanding symptoms of dyspnoea on exertion as well as a minor stroke several years ago. Computed tomography on admission suggested there was a mass in the LA but transthoracic echocardiography and cardiac magnetic resonance imaging revealed the diagnosis of partial CTS in which the superior compartment received pulmonary venous drainage from the right lung and the left-sided pulmonary veins drained into the inferior chamber. Since there were signs of chronic pulmonary oedema she successfully underwent balloon dilatation of the membrane resulting in remission of symptoms and normalization of the pressure in the accessory chamber.DiscussionPartial CTS is a rare variant of CTS. Since part of the pulmonary veins drains in the lower chamber of the LA (and thereby unload the right ventricle), it is a favourable variant and patients may present later in life when membrane orifices calcify or it may be discovered as an incidental finding. In some patients requiring intervention, balloon dilatation of the membrane may be considered as an alternative to surgical removal of the membrane by thoracotomy.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

Reference12 articles.

1. Cor triatriatum: clinical, hemodynamic and pathological studies: surgical correction in early life;Jegier;Pediatrics,1963

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3. Cor triatriatum in adults: three new cases and a brief review;Chen;Tex Heart Inst J,1999

4. Cor triatriatum sinistrum diagnosed in the adulthood: a systematic review;Rudienė;Heart,2019

5. Doppler echocardiographic findings in 2 identical variants of a rare cardiac anomaly, ‘subtotal’ cor triatriatum: a critical review of the literature;Buchholz;J Am Soc Echocardiogr,2001

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