title: Cathether-based interventional strategies for cor triatriatum in the adult - feasibility study through a hybrid approach.
abstract: BACKGROUND
  Cor triatriatum is a rare congenital cardiac abnormality, consisting of an obstructing membrane between the pulmonary veins and the mitral valve in varying patterns. The entitiy can mimick the pathophysiology of mitral stenosis, necessitating surgical resection. Occasionally, percutaneous balloon dilatation of the membrane has been successfully performed.
  
  
  METHODS
  We report two cases with cor triatriatum where intraoperative balloon dilatation of the membrane was attempted followed by surgical resection, to explore the feasibility of cathether-based interventional strategies for cor triatriatum.
  
  
  CONCLUSIONS
  Various anatomical variations exist of cor triatriatum, depending on the drainage of the pulmonary veins and the drainage of the proximal chamber in the right or left atrium. Only isolated forms of cor triatriatum where all pulmonary veins ultimately drain into the left atrium can be recommended for percutaneous strategies. In addition, several anatomical characteristics should be considered to predict technical success of cathether-based interventional strategies, such as the location of the membrane, the degree of pulmonary vein stenosis, the extent of calcification, and the presence of other (congenital) cardiovascular abnormalities. Furthermore, long-term efficacy of these strategies remains to be confirmed. As such, surgical treatment of cor triatriatum remains the mainstay of treatment in adult patients, especially when other cardiovascular anomalies are present which require surgical correction.
authors.affiliation: Department of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. w.w.li@amc.uva.nl.
authors.forename: Wilson W
authors.initials: WW
authors.lastname: Li
authors.affiliation: Department of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. d.r.koolbergen@amc.uva.nl.
authors.forename: David R
authors.initials: DR
authors.lastname: Koolbergen
authors.affiliation: Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. b.j.bouma@amc.uva.nl.
authors.forename: Berto J
authors.initials: BJ
authors.lastname: Bouma
authors.affiliation: Department of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.g.hazekamp@lumc.nl.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Hazekamp
authors.affiliation: Department of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. b.a.demol@amc.uva.nl.
authors.forename: Bas A
authors.initials: BA
authors.lastname: de Mol
authors.affiliation: Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. r.j.dewinter@amc.uva.nl.
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D006328:Cardiac Catheterization / Q000379:methods*; D003310:Cor Triatriatum / Q000000981:diagnostic imaging* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D014463:Ultrasonography