Diagnosis of a Very Rare Variant of Cor Triatriatum Dexter by Contrast Echocardiography: A Case Report

Cor triatriatum dexter is a rare congenital abnormality in which the right atrium is divided into two chambers by a membrane. A rare variant of cor triatriatum dexter where the membrane is attached to the left of the superior vena cava at one end and to the right of inferior vena cava and coronary sinus at the other end has been described only once before. We describe here a case of this very rare variant of cor triatriatum dexter that was diagnosed using contrast echocardiography.     

Cor Triatriatum Dexter: An Innocent Bystander

Cor triatriatum dexter is a rare congenital heart defect with a varied clinical presentation ranging from asymptomatic to right heart failure. Accurate diagnosis is imperative as it may affect clinical decision making. We present a multimodality imaging assessment of cor triatriatum dexter in a 70-year-old woman with severe tricuspid regurgitation.     

Pitfalls in the diagnosis of tricuspid atresia: report of a new angiocardiographic sign

Two patients with the classical clinical, angiographic, and echocardiographic signs of tricuspid atresia are reported, where the correct diagnoses were made at operation; one child had cor triatriatum dexter, the other child total anomalous systemic venous drainage to the left atrium. The literature on cor triatriatum dexter and total anomalous systemic venous drainage is discussed and a new angiographic sign for the differentiation from tricuspid atresia is reported: nonopacification of the right atrial appendage with right atrial angiocardiography.     

Cor triatriatum dexter: recognition and percutaneous transluminal correction

Cor triatriatum dexter is a rare congenital anomaly in which an obstructive membrane is located in the right atrium. The detection usually occurs after the sequelae of systemic congestion, coagulopathy, and hepatic dysfunction have set in, leading up to a high surgical risk. A percutaneous balloon correction of cor triatriatum dexter in a patient with advanced right-sided congestive symptoms and hepatic dysfunction is presented. This efficacious method is an alternative to surgical correction and could be extended to the more common cor triatriatum sinistra.     

Cor Triatriatum Dexter and Atrial Septal Defect in a 43-Year-Old Woman

Cor triatriatum dexter is a rare congenital heart anomaly in which a membrane divides the right atrium into 2 chambers. We report the case of a 43-year-old woman who had cor triatriatum dexter and a large atrial septal defect. During attempted percutaneous closure, the balloon disrupted the membrane and revealed that the defect had no inferior rim, precluding secure placement of an Amplatzer Septal Occluder. Surgical treatment subsequently proved to be successful.In patients with an incomplete membrane and a septal defect with well-defined rims, percutaneous treatment can be the first choice. In patients who have cor triatriatum dexter and unfavorable anatomic features or concomitant complex heart anomalies, open-heart surgery remains the gold standard for treatment.     

Cor triatriatum dexter: antemortem diagnosis in an adult by cross sectional echocardiography

Cor triatriatum dexter is a rare cardiac abnormality in which the right atrium is subdivided into two distinct chambers. This anomaly is generally attributed to the persistence of the right sinus venosus valve and it is frequently associated with severe malformations of other right heart structures. The antemortem diagnosis of the membrane may be difficult and its presence is often only established at necropsy. In a woman of 56 with Ebstein's anomaly the echocardiographic features of cor triatriatum dexter were examined before and during cardiac catheterisation. These investigations showed the position of the membrane, that there was no gradient between the two atrial chambers, and that there were perforations in the centre of the membrane.     

Cor triatriatum dexter: antemortem diagnosis in an adult by cross sectional echocardiography.

Cor triatriatum dexter is a rare cardiac abnormality in which the right atrium is subdivided into two distinct chambers. This anomaly is generally attributed to the persistence of the right sinus venosus valve and it is frequently associated with severe malformations of other right heart structures. The antemortem diagnosis of the membrane may be difficult and its presence is often only established at necropsy. In a woman of 56 with Ebstein's anomaly the echocardiographic features of cor triatriatum dexter were examined before and during cardiac catheterisation. These investigations showed the position of the membrane, that there was no gradient between the two atrial chambers, and that there were perforations in the centre of the membrane.     

Cor triatriatum dexter with imperforate Ebstein's anomaly.

A case of cor triatriatum dexter is described in which the anomalous right atrial partition is identified as the right venous valve; there is an associated anomaly of the right atrioventricular valve which combines features of Ebstein's anomaly, and an atypical, imperforate, tricuspid atresia.     

Cor Triatriatum Dexter,Atrial Septal Defects,and Pulmonary Stenosis—A Rare Association

Cor triatriatum dexter (CTD) is an extremely rare congenital anomaly in which the right atrium is divided into 2 chambers by a membrane. The estimated incidence of cor triatriatum has been reported as 0.1% of congenital cardiac malformations. The septation of the right atrium in the setting of CTD is the result of failed resorption of the right valve of the sinus venosus. This results in anterolateral and posteromedial portions of the divided right atrium. CTD can be diagnosed at any age, especially if it is incidentally discovered.     

Cor triatriatum dexter: two-dimensional echocardiographic diagnosis

Cor triatriatum dexter is a malformation resulting from lack of normal regression of the embryonic right valve of the sinus venosus. In this situation, the right atrium is divided by a membrane into two chambers. Two-dimensional echocardiography was used in the antemortem diagnosis of this rare cardiac anomaly in a neonate. Associated cardiac lesions were also documented. The patient died, and findings were verified at autopsy.     

Cor triatriatum dexter with imperforate Ebstein's anomaly.

A case of cor triatriatum dexter is described in which the anomalous right atrial partition is identified as the right venous valve; there is an associated anomaly of the right atrioventricular valve which combines features of Ebstein's anomaly, and an atypical, imperforate, tricuspid atresia.     

Echocardiographic diagnosis of the right tri-atrial heart

In this report we describe the two-dimensional echocardiographic features of a case of cor triatriatum dexter. In this situation the right atrium is divided by a membrane in two chambers. Considering the anatomic characteristics of this case we added a new type in the classical classification proposed by Doucette et al.     

Cor triatriatum dexter associated with atrial septal defect: Management in a complex clinical case

The coexistence of an atrial septal defect and a prominent eustachian valve is a rare congenital anomaly, rarely reported in literature. Differentiation between a giant eustachian valve and cor triatriatum dexter can be difficult. A case of a large atrial septal defect associated with cor triatriatum dexter diagnosed by echocardiography in an asymptomatic woman is reported. A watchful waiting strategy was adopted.     

Cor triatriatum dexter masquerading as Ebstein's anomaly

We report the case of a child with cor triatriatum dexter masquerading as Ebstein's anomaly on transthoracic echocardiography. This was attributed to a floppy membrane arising from the right atrium, protruding into the tricuspid valve and pushing the leaflets downwards, giving an impression of Ebstein's anomaly. The importance of recognising this pitfall will prevent misdiagnosis of Ebstein's anomaly.     

Unique Sail‐Like Structure of Cor Triatriatum Dexter in Three‐Dimensional Echocardiogram

Cor triatriatum dexter (CTD) is an extremely rare congenital condition arising from the persistence of the right valve of the sinus venosus. It divides the right atrium (RA) into 2 separate chambers. We report a case of a 50‐year‐old man who had an incidental finding of CTD on transesophageal echocardiogram. An incomplete membrane of the RA was seen, and three‐dimensional echocardiogram delineated the structure clearly as a triangular sail‐like structure with multiple orifices and a fenestration.     

Cor triatriatum dexter. Persistent right sinus venosus valve

The usual causes of a large right to left shunt at the atrial level are tricuspid or pulmonary atresia, severe pulmonary stenosis, Ebstein's anomaly or a large atrial septal defect with pulmonary hypertension. We have recently evaluated a patient with a large right atrial membrane which subdivided the right atrium into 2 chambers with the venae cavae and foramen ovale on one side of the web and the coronary sinus and a small tricuspid valve on the other. The presence of this membrane was demonstrated preoperatively by cineangiograms, and it was successfully removed at operation. This unusual entity, cor triatriatum dexter, is discussed and the literature reviewed.     

Three-Dimensional Echocardiographic Reconstruction of Atrial Membranes

Three-dimensional echocardiographic findings in cor triatriatum sinister (sinistrum), cor triatriatum dexter, mitral supravalvular membrane, and atrial baffle are presented.     

Giant eustachian valve with echocardiographic appearance of divided right atrium

The eustachian valve is an embryologic remnant of the valve of the inferior vena cava. It may be prominent in some individuals, but the echocardiographic appearance of a divided right atrium, as the consequence of a large eustachian valve, is extremely rare. Herein we describe an unusual giant eustachian valve with an echocardiographic appearance of a septal structure dividing the right atrium into 2 separate chambers. This abnormality should be differentiated from cor triatriatum dexter, a very rare cardiac malformation for which it could be mistaken.     

Postsurgical use of amplatzer septal occluder in cyanotic patients with pulmonary atresia/intact ventricular septum: significance of cor triatriatum dexter and dilated right atrium.

Percutaneous closure of secundum atrial septal defects (ASDs) has been shown to be safe and effective. However, its role after surgery in patients with cyanotic congenital heart disease who may have associated cor triatriatum dexter and a dilated right atrium has not been established. This article reports on successful closure in such patients, including precautions and results.     

First Case of Complete Percutaneous Correction of Isolated Divided Atrium (or Cor Triatriatum) Dexter

Divided atrium (or Cor triatriatum) dexter (DAD) is a rare congenital cardiopathy, usually associated with other anomalies; isolated forms are even rarer. We report the case of an 84-year-old woman presenting with isolated DAD complicated by right–left atrial shunt through patent foramen ovale (PFO), revealed by right cardiac failure and severe hypoxemia. Late destabilization was caused by total superior vena cava thrombosis, related to her pacemaker. Given the overall context, complete percutaneous treatment was performed, associating PFO occlusion and stent implantation in the right atrial membrane, providing total regression of symptoms. Thus, percutaneous correction of DAD appears to be safe and effective.