Assessment of Cor Triatriatum Sinistrum by Magnetic Resonance Imaging
A 44-year-old asymptomatic man with hypertension was referred to our institution for cardiac examination. Transthoracic Doppler echocardiography, limited by poor imaging quality, suggested a linear echodense structure within the left atrium. Further noninvasive evaluation was performed by MRI at 1.5 T.
Dark blood–prepared spin-echo MR images of the heart revealed a membrane in the cranial part of the left atrium emerging from the interatrial septum toward the entrance of the left atrial appendage, subdividing the left atrium into a proximal and distal chamber (Figure 1). Both cavities were connected by a large orifice within the membrane (Figure 2). All pulmonary veins drained into the proximal cavity of the left atrium, and no further cardiac abnormalities were detected leading to the diagnosis of classical cor triatriatum sinistrum. On cine images, a nonturbulent diastolic flow through the opening was demonstrated suggesting no hemodynamically relevant obstruction (Movies 1 and 2).
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The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
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