Cor triatriatum sinister in an adult: management guided by real time three-dimensional transesophageal echocardiography and stress echocardiography.
A 39-year-old female had cor triatriatum (CT) detected as an incidental finding on transthoracic echocardiography performed to evaluate chest pain. By conventional two- and real time three-dimensional transesophageal echocardiography, the CT membrane had a communicating orifice connecting the accessory and main left atrial chambers that measured 1.3 × 0.8 cm. The resting mean transmembrane gradient was 2 mm Hg. The postexercise mean transmembrane gradient and pulmonary artery pressure were 6 and 40 mm Hg. Extrapolating from cutoff values for postexercise gradients and pulmonary pressures in patients with mitral stenosis, we advised deferring surgery and close clinical and echocardiographic follow up.
Willens
Howard J
HJ
Department of Medicine, Division of Cardiology, University of Miami Miller School of Medicine, Miami, Florida, USA. hwillens@med.miami.edu
Ferrer
Peter L
PL
Tamer
Dolores F
DF
Labrador
Eugenio
E
Agatston
Arthur S
AS
Keith
Karen
K
Torres
Silvia
S
D000328:Adult; D003199:Computer Systems; D003310:Cor Triatriatum / Q000000981:diagnostic imaging* / Q000601:surgery*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D011379:Prognosis; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome