title: Incomplete Cor Triatriatum Dexter and Its Clinical and Technical Implications in Interatrial Shunt Device-Based Closure: An Intracardiac Echocardiography Study.
abstract: OBJECTIVE
  Cor triatriatum dexter (CTD) is a congenital anomaly in which the right atrium is divided into two parts by a membrane or fibromuscular band. Incomplete separation of the right atrium may occur when prominent venous valve remnants such as Eustachian valve (EV) or Chiari network (CN) incompletely divided the right atrium (incomplete CTD-iCTD). We sought to assess the incidence of EV/CN and iCTD and its clinical and technical implications in patients submitted to interatrial shunt transcatheter closure.
  
  
  METHODS
  Retrospective analysis of single center registry.
  
  
  METHODS
  Secondary referral center.
  
  
  METHODS
  Five hundred eighty consecutive patients (mean age 44 ± 15.5 years, 385 females) who had been submitted over a 12 years period to intracardiac echocardiography-aided interatrial shunt catheter-based closure.
  
  
  METHODS
  Prevalence of iCTD and EV/CN, shunt grade, right ventricle diameter, incidence of intraprocedural complications.
  
  
  RESULTS
  In patients with PFO, a prominent EV or a large CN and iCTD have been diagnosed in was diagnosed on ICE in 51.1% and 5.2%, respectively. In ASD patients, a prominent EV or a large CN and iCTD were apparent in 13.7% and 5.6%, respectively. PFO patients with iCTD had more frequently a curtain pattern on TC Doppler and a larger right-to-left shunt graded than prominent EV/CN patients and patients without. ASD patients with iCTD had larger right ventricle diameter than both ASD patients with EV/CN and patients without. iCTD was associated with 45.1% of patients with intraoperative complications.
  
  
  CONCLUSIONS
  iCTD are not so infrequently observed by ICE during interatrial shunt closure procedure. Presence of this peculiar structure should be taken in account during device-based procedure in the right atrium.
authors.affiliation: Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy. jackyheart@libero.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rigatelli
authors.affiliation: Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Dell'Avvocata
authors.affiliation: Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Giordan
authors.affiliation: Division of Cardiology, Sant Katerinen Hospital, Sofia University Medical School, Sofia, Bulgaria.
authors.forename: Dobrin
authors.initials: D
authors.lastname: Vassilev
authors.affiliation: Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cardaioli
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D003310:Cor Triatriatum / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D055989:Septal Occluder Device; D016896:Treatment Outcome
keywords: Atrial Septal Defect; Cardiac Anatomy; Echocardiography; Patent Foramen Ovale