Minimally Invasive Periareolar Approach to Cor Triatriatum Repair

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2014

Cor triatriatum sinister (CTS) is a rare developmental cardiac abnormality resulting in left ventricular inflow obstruction. In this report, we aimed to present our mid-term results of early childhood patients operated for CTS and associated cardiac abnormalities. We enrolled 15 patients with CTS who were operated by a single surgeon between 2001 and 2013. A retrospective analysis was performed in order to determine the demographics, operative and postoperative results of the patients. The median age was 14 months and the median body weight was 8.2 kg at the time of operation. Fourteen patients had concomitant cardiac pathology. Three of the patients had atrial septal defect and 1 of the patients had partial abnormal pulmonary venous connection, whereas 4 of the patients had both. In 2 cases of complete atrioventricular septal defect, 1 case with ventricular septal defect, 1 case with patent ductus arteriosus, 1 case with double outlet right ventricle and another case with tetralogy...

Annals of Thoracic Surgery, 2006

This is a case of cor triatriatum with unroofed coronary sinus without the left SVC in an adult patient. The coronary sinus was created using the left atrial diaphragm flap. The ASD was closed with his own atrial septum and the large Thebesian valve so that the coronary veins could return to the right atrium. The advantages of the present methods are (1) no materials other than autologous intracardiac components are used to repair all anomalies, (2) all major coronary veins returned to the right atrium, (3) the coronary sinus was created with thick and flexible in situ muscle flap so that the new roof of the coronary sinus could not be deformed.

Medicina

Background and Objectives: A rare case of cor triatriatum sinistrum in combination with anomalies in the atrial septum and in the right atrium of a 60-year-old female body donor is described here. Materials and Methods: In addition to classical dissection, ultrasound and magnetic resonance imaging, computer tomography and cinematic rendering were performed. In a reference series of 59 regularly formed hearts (33 men, 26 women), we looked for features in the left and right atrium or atrial septum. In addition, we measured the atrial and ventricular wall thickness in 15 regularly formed hearts (7 men, 8 women). Results: In the case described, the left atrium was partly divided into two chambers by an intra-atrial membrane penetrated by two small openings. The 2.5 cm-high membrane originated in the upper level of the oval fossa and left an opening of about 4 cm in diameter. Apparently, the membrane did not lead to a functionally significant flow obstruction due to the broad intra-atria...

Journal of the American Society of Echocardiography, 1990

A 74-year-old man was admitted to the hospital with congestive heart failure secondary to cor triatriatum. He also had sick sinus syndrome with complete heart block and syncope that had been treated with a permanent pacemaker 20 years earlier. The patient underwent successful surgical resection of the atrial membrane with closure of an atrial septal defect. M-mode, two-dimensional, Doppler, and transesophageal echocardiographic findings are reviewed. A unique "spike and dome" pattern on continuous-wave Doppler echocardiography is described that may suggest diagnosis of cor triatriatum. (J AM Soc ECHO 1990;3:402-7.) Cor triatriatum is a rare congenital cardiac malformation. 1 ,2 It is primarily seen in the pediatric age group and is uncommon in adults. Two 52-year-old patients have been reported as the oldest living patients with cor triatriatum. One of these patients died during a surgical correction 3 ; the other awaited a surgical correction. 4 This is a case report of cor triatriatum presenting as congestive heart failure in a 74-year-old white man. This patient also has a history of sick sinus syndrome with complete heart block that required a permanent VVI pacemaker. He underwent successful surgical correction. Echocardiographic features of cor triatriatum are reviewed, including characteristic Doppler and transesophageal findings before and after surgical correction.

The Annals of thoracic surgery, 2016

Less invasive techniques are commonly used to treat patients with anatomically suitable secundum atrial septal defects; however, repair of more complex atrial septal defects are still performed through sternotomy. Cosmetically appealing periareolar incisions have been used in breast reconstructive surgery and may provide an esthetically superior alternative to the anterolateral minithoracotomy incision used in minimally invasive cardiac surgery. We describe a patient with an unroofed coronary sinus atrial septal defect who underwent successful minimally invasive, endoscopic repair of this defect with autologous pericardial baffle reconstruction of the coronary sinus roof and closure of the interatrial communication through a periareolar approach.

The Annals of thoracic surgery, 2017

Cor triatriatum sinister is a rare congenital lesion encountered in children. It consists of a fibromuscular membrane that separates the left atrium into two chambers resulting in a triatrial heart and often occurs with other structural cardiac anomalies. The acquired form is uncommon and has only been reported after orthotopic heart transplantation or as a complication of infective endocarditis in adults. These cases were mostly because of hypertrophied atrial tissue or suture lines and torsion of the atrium. We describe the first case of acquired cor triatriatum late after the Fontan procedure with successful surgical resection in a child.

The Annals of Thoracic Surgery, 2020

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World journal for pediatric & congenital heart surgery, 2015

Atrioventricular septal defect can present with one or more associated anomalies. Cor triatriatum (subdivided left atrium) and vascular rings are among the less frequent. We describe a two-month-old patient with these three cardiovascular anomalies. This case highlights the importance of exhaustive preoperative evaluation in order to achieve successful surgical correction in one stage.

Echocardiography, 2005

We present the case of an asymptomatic 21-year-old woman referred because of an abnormal routine electrocardiogram. Transthoracic and transesophageal echocardiography revealed a complete absence of the atrial septum, a common atrium septated posteriorly from the pulmonary venous chamber, a partial atrioventricular canal, a cleft mitral valve and a persistent left superior vena cava draining into an enlarged coronary sinus. These findings were confirmed during surgical correction. Our patient presented with an unusual and fascinating combination of congenital malformations that remained well tolerated and undiscovered into adulthood.

F1000Research, 2022

Cor triatriatum is an extremely rare cardiac congenital malformation characterized by subdivision of the left atrium into two chambers. This division is due to the presence of an abnormal fibromuscular membrane interrupted by one or more openings that communicate the two chambers. The size and number of those orifices is variable, affecting the age of onset of symptoms and their severity. Our case describes the fortuitous discovery of this pathology in a young adult in her forties, following the finding of atrial fibrillation during a preoperative assessment of a strangulated hernia. The cardiac ultrasound allowed in our case to invoke the diagnosis, confirmed thereafter with an angioscanner. Surgical resection was not required in our patient who was put on medical treatment involving a beta-blocker to reduce atrial fibrillation and an anticoagulant treatment to decrease the thromboembolic risk, with a good clinical evolution. It seems therefore interesting to consider this uncomm...