:These transesophageal echocardiograms were obtained in an 18-month-old, 8.8-kg infant with cor triatriatum. The images define the membranous structure in cor triatriatum that represents the line of fusion between the pulmonary venous component and the left atrial component. Because of direction of flow, the membrane bulges toward the mitral valve (Fig 1⇓). Color flow imaging (Fig 2⇓) demonstrates the high-velocity flow through the orifice on the side closest to the atrial septum, with proximal flow acceleration on the surface of the membrane. The Doppler color flow imaging complements the two-dimensional imaging and demonstrates the location of obstruction.
1. Shuler OC, Fyfe DA, Sade R, Crawford FA. Transesophageal echocardiographic evaluation of cor triatriatum in children. Am Heart J. 1995;129:507-510.
2. Ostman-Smith I, Silverman NH, Oldershaw P, Lincoln C, Shinebourne EA. Cor triatriatum: diagnostic features on cross-sectional echocardiography. Br Heart J. 1984;51:211-219.
3. Lengyel M, Arvay A, Biro V. Two-dimensional echocardiographic diagnosis of cor triatriatum. Am J Cardiol. 1987;59:484-485.
4. Seward JB, Tajik AJ. Transesophageal echocardiography in congenital heart disease. Am J Card Imaging. 1990;4:215-222.
5. Schluter M, Langenstein BA, Their W, Schmiegel W-H, Krebber H-J, Kalmar P, Hanrath P. Transesophageal two-dimensional echocardiography in the diagnosis of cor triatriatum in the adult. J Am Coll Cardiol. 1983;2:1011-1015.
6. Tuccillo B, Stumper O, Hess J, Van Suijlen RJ, Bos E, Roelandt JRTC, Sutherland GR. Transesophageal echocardiographic evaluation of atrial morphology in children with congenital heart disease. Eur Heart J. 1992;13:223-231.
7. Ludomisky A, Erickson C, Vick WG, Cooley DA. Transesophageal color flow Doppler evaluation of cor triatriatum in an adult. Am Heart J. 1990;120:451-455.
8. Kacenelenbogen R, Decoodt P. Biplane transesophageal echocardiographic diagnosis of cor triatriatum. Chest. 1994;105:601-602.
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.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.
1 The assistance of Hewlett Packard is gratefully acknowledged.
- Copyright © 1997 by American Heart Association