COR TRIATRIATUM: CLINICAL, HEMODYNAMIC AND PATHOLOGICAL STUDIES: SURGICAL CORRECTION IN EARLY LIFE

Abstract

Experiences with three patients with cor triatriatum illustrate the urgent need for early recognition of this obstructing diaphragm in the left atrium. A 4-month old infant died with severe and progressive heart failure before cardiac studies were completed. A 3-year-old girl was under observation for one year prior to death in acute pulmonary edema. In spite of extensive studies the diagnosis was not established. A 16-month-old male had increasing dyspnea and fatigue for 3 weeks prior to referral. The hemodynamic studies revealed marked elevation of pulmonary capillary and pulmonary artery pressures. Unusual features included a continuous murmur high in the left axilla and striking enlargement of the left atrium. Excision of the obstructing membrane was accomplished at open operation with cardiopulmonary bypass, and striking clinical improvement has been maintained for 3 years.