Adult Obstructive Cor Triatriatum with Severe Mitral Regurgitation: A Case Report

Authors

  • Tomomi Nakajima, MD Department of Cardiac Surgery, Heart Institute of Ho Chi Minh City-Alan Carpentier Foundation, Ho Chi Minh City, Vietnam
  • Dung Van Hung, MD, PhD Department of Cardiac Surgery, Heart Institute of Ho Chi Minh City-Alan Carpentier Foundation, Ho Chi Minh City, Vietnam
  • Yuji Hiramatsu, MD, PhD Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

DOI:

https://doi.org/10.1532/hsf.3871

Keywords:

Cor Triatriatum, Mitral regurgitation, Obstractive cor triatriatum, Mitral stenosis

Abstract

Adult cor triatriatum sinister associated with severe mitral regurgitation is extremely rare. As these obstructive cor triatriatum feature hemodynamics that mimic mitral stenosis, a pressure load is theoretically generated only on the left atrial proximal chamber, and therefore the left ventricle is less likely to suffer volume loading. Here, we report a surgical case with such rare hemodynamics. A 22-year-old man with obstructive cor triatriatum and severe mitral regurgitation received an anomalous membrane excision and mitral annuloplasty. An abnormal membrane with an orifice
7 mm in size was completely resected while a grossly dilated mitral annulus was repaired via annuloplasty ring. Mitral regurgitation was controlled well, and the postoperative course was uneventful. Even with obstructive cor triatriatum, severe mitral annular dilatation and subsequent left ventricular dilatation may occur, causing the progressive heart failure encountered in this case.

References

Eichholz JL, Hodroge SS, Crook II JJ, Mack Jr JW, Wortham DC. 2013. Cor triatriatum sinister in a 43-year-old man with syncope. Tex Heart Inst J 40:602-5.

Fujii S, Gottschalk BH, Iglesias I, Evans B, Hage A, Chu MWA. 2020. Endoscopic repair of obstructive cor triatriatum. CASE (Phila) 4:82-5.

Jayaprakash K, Madhavan S, Kumary VS, George R, Cletus N, Baiju S. 2015. Wong’s anomaly – A rare variant of cor triatriatum. Indian Heart J 67:469-71.

Nakajima H, Kobayashi J, Kurita T, Kitamura S. 2002. Maze procedure and cor triatriatum repair. Ann Thorac Surg 74:251-3.

Niwayama G. 1960. Cor triatriatum (review). Am Heart J 59:291-317.

Rodefeld MD, Brown JW, Heimansohn DA, et al. 1990. Cor triatriatum: clinical presentation and surgical results in 12 patients. Ann Thorac Surg 50:562-8.

Rudiene V, Hjostshoj CMS, Glaveckaite S, et al. 2019. Cor triatriatum sinistrum diagnosed in the adulthood: a systematic review. Heart. 105:1197-202.

Wong CK, Leung WH, Cheng CH, Lau CP, Cheung DLC. 1989. Myxomatous mitral valve degeneration complicating asymptomatic cor triatriatum. Clin Cardiol. 12:48-50.

Published

2021-06-25

How to Cite

Nakajima, T., Van Hung, D., & Hiramatsu, Y. (2021). Adult Obstructive Cor Triatriatum with Severe Mitral Regurgitation: A Case Report. The Heart Surgery Forum, 24(3), E578-E579. https://doi.org/10.1532/hsf.3871

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