Surgical Treatment of Cor Triatriatum

삼방심의 외과적 치료 -수술치험 24례-

  • Published : 1994.04.01

Abstract

Cor triatriatum is a relatively rare cardiac anomaly, whose major feature is a fenestrated membrane separating an upper common pulmonary venous chamber from a lower true left atrial cavity. Interatrial communications may be present between the right atrium and the common pulmonary venous chamber or the true left atrium. From April 1981 to April 1992, 24 patients with cor triatriatum were treated at Seoul National University Hospital. Ages ranged from 1 month to 24 years with mean of 7.4 years. Twenty patients had interatrial communications through a patent foramen ovale, primum or secundum defect of the atrial septum. Four had no interatrial communications. Fourteen patients had associated anomalies; partial anomalous pulmonary venous connection in 3, total anomalous pulmonary venous connection in 2, persistent left superior vena cava in 3, and other anomalies in 6 patients. Surgical corrections were performed through right atriotomy in 18 patients, left atriotomy in 4, and both atriotomy in 2. Three patients [12.5%] died early after operation; two of them were associated with single ventricle. Six out of 21 survivors [28.6%] experienced complications; recurrent pneumonia, pulmonary embolism, ischemic encephalopathy, diaphragmatic palsy and tachyarrhythmias. At the time of follow up, all survivors, except one, were in functional class I. Surgical correction of cor triatriatum restored normal hemodynamic status with relatively low operative mortality, especially in patients not complicated with severe anomalies. This report summarizes the clinical diagnosis, associated anomalies, interatrial communications, surgical approach and late result of 24 patients underwent surgical corrections in our hospital.

Keywords

References

  1. Trans Pathol Soc Lond v.19 Congenital malformation of the heart:abnormal septum in left auricle Church,W.S.
  2. Surg Gynecol Obstet v.102 Direct vision repair of triatriatal heart and total anomalous pulmonary venous drainage Lewis,F.J.;Varco,P.L.;Taufic,M.;Niazi,S.A.
  3. Can Med Assoc J v.74 Report of a successful operation for stenosis of common pulmonary vein (cor triatriatum) Vineberg,A.;Gialloreto,O.
  4. 대흉외지 v.16 삼중방심 치험 1례 정경영;이두연;홍승록;이웅구
  5. 대흉외지 v.17 폐정맥 환류이상을 동반한 삼중방심 치험 1례 김영호;김공수
  6. 대흉외지 v.18 삼중방심 치험 1례 노중기;이길노
  7. 대흉외지 v.18 부분 폐정맥 환류이상과 심방중격 결손증을 동반한 삼중방심의 치험 1례 이철주;이동협;전진곤;조범구
  8. 대흉외지 v.18 좌측상공정맥을 동반한 삼중방증 박병순;오봉석;김상형;박옥규;이동준
  9. 대흉외지 v.22 삼중방심 치험 1례 안강진;여승동;주홍돈(등)
  10. Anat Res v.143 Classification of triatriatal hearts James,T.N.
  11. Am Heart J v.78 Cor triatriatum:pathologic anatomy and a consideration of morphogenesis based on 13 postmorterm cases and a study of normal development of the pulmonary vein and atrial septum in 83 human embryos Van Praagh,R.;Corsini,I.
  12. Am J Cardiol v.37 Subdevided left atrium:An expanded concept of cor triatriatum sinistrum Thilenius,O.G.;Bharati,S.;Lev,M.
  13. Trans Pathol Soc London v.33 Membranous band in the left auricle Fowler,J.K.
  14. J Anat Physiol v.37 Note on a second example of division of the cavity of the left auricle into two compartments by a fibrous band Griffith,T.W.
  15. Arch Pathol v.48 Unusual malformation of the left atrium:Pulmonary sinus Loeffler,E.
  16. Am J of Cardiology v.35 Cor Triatriatum:Study of 20 cases Marin Garcia,J.;Tandon,R.;Lucas,R.V.;Edwards,J.E.
  17. J Thorac Cardiovasc Surg v.81 Cor triatriatum (subdivided left atrium) Richardson,J.V.;Doty,D.B.;Siewers,R.D.;Zuberbuhler,J.R.
  18. Ann Thorac Surg v.35 Cor Triatriatum:Operative result in 25 patients Oglietti,J.;Cooley,D.A.;Izquierdo,J.P.;Ventemiglia,R.;Muasher,I.;Hallman,G.L.;Reul,G.J.
  19. J Thorac Cardiovasc Surg v.101 Cor triatriatum:Clinical presentation and operative results Salomone,G.;Tiraboschi,R.;Bianchi,T.;Ferri,F.;Crippa,M.;Parenzan,L.
  20. Am Heart J v.94 A proposed pathogenesis of cor triatriatum:Impingement of the left superior vena cava on the developing left atrium Gharagozloo,F.;Bulkley,S.;Lev,M.
  21. Ann Thorac Surg v.32 Surgical treatment of Cor triatriatum Archiniegas,E.;Zia,Q.F.;Mehdi,H.;Burton,L.P.;Edward,W.G.
  22. Cardiac surgery Cor Triatriatum Kirklin,J.W.;Barratt Boyes,B.G.;Kirklin,J.W.(ed.);Barratt Boyes,B.G.(ed.)
  23. Am J Cardiol v.49 Concealed left atrial membrane:pitfalls in the diagnosis of cor triatriatum and supravalve mitral ring Jacobstein,M.D.;Hirschfeld,S.S.