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Insuficiencia cardíaca

versión On-line ISSN 1852-3862


BARBAGLIA, Federico Gerardo; CASANOVA, Martín José; ARAUJO, Ramón Adrián  y  TAZAR, Jorge Isaac. Cor triatriatum sinister: Report of a case. Insuf. card. [online]. 2010, vol.5, n.1, pp.42-47. ISSN 1852-3862.

The cor triatriaum sinister is a very rare cause of pulmonary venous hypertension and congestive heart failure, with a reported incidence of 0.1% of children with congenital heart defects. The natural history of this defect depends on the size of the hole in the membrane. It is characterized by the presence of a fibromuscular membrane dividing the left atrium into two chambers, connected by one or several holes, with varying degrees of obstruction. The obstructive form part may be asymptomatic and diagnosed incidentally by an echocardiogram. It is frequently associated with other congenital anomalies including a atrial septal defects (ASD). We report the case of a 43 year old hypertensive woman with a history of direct closure of ASD 8 months ago, confirmed diagnosis by transesophageal echocardiography (TEE). She consults her doctor for sudden onset of precordial palpitations. The electrocardiogram showed atypical atrial flutter. The patient was hospitalized for electrical cardioversion. During the execution of an TEE, we found consistent findings with cor triatriatum: shunt through an ASD from left to right; severe tricuspid regurgitation, gradient between right ventricle and atrium of 65 mm Hg; pulmonary systolic pressure rated at 85 mm Hg. After the resolution of the arrhythmia, we performed a right atriotomy through the ASD, resecting the obstructive membrane, ASD closes again with a large patch of dacron. Currently the patient presents a good outcome in cardiological clinical monitoring.

Palabras clave : Cor triatriatum sinister; Atrial septal defect; Atrial flutter; Transesophageal echocardiogram; Surgical resolution.

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