A Rare Association of Cor Triatriatum Sinister With Congenitally Corrected Transposition of Great...
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IMAGES IN CARDIOLOGY A Rare Association of Cor Triatriatum Sinister With Congenitally Corrected Transposition of Great Arteries Jebaraj Rathina Samy, MD, Manokar Panchanatham, MD, DM, Murthy Jayanti Sathya Narayana, MD, DNB, Thanikachalam Sadagopan, MD, DM, DSC Chennai, India A 32-year-old male was evaluated during a general health checkup. Clinical examination and transthoracic echocardiography revealed situs inversus with mesocardia. The details of intracardiac anatomy could not be obtained due to restricted echo windows. He underwent cardiac magnetic resonance imaging for comprehensive evaluation. Evaluation showed situs inversus, mesocardia, congenitally corrected transposition of great arteries (CCTGA), and cor triatriatum sinister (A to C, Online Video 1) with moderate pulmonary hypertension. There was a peak gradient of 1.5 m/s on velocity encoded through plane imaging of the restrictive orifice of cor triatriatum (D to G, Online Video 2). It is well known that an additional abnormality causing higher morphological left ventricular pressure improves tricuspid regurgitation and symptoms in CCTGA. In this patient, the clinical management dilemma is because the obstructed cor triatriatum (C and E, arrowheads) is probably maintaining the higher morphological left ventricular pressure. From the Department of Cardiology, Cardiac Care Centre, Sri Ramachandra University, Chennai, India. Manuscript received June 19, 2013; accepted July 9, 2013. Journal of the American College of Cardiology Vol. 62, No. 25, 2013 Ó 2013 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jacc.2013.07.109
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Transcript of A Rare Association of Cor Triatriatum Sinister With Congenitally Corrected Transposition of Great...
From the Department of
Cardiology, Cardiac Care
Centre, Sri Ramachandra
University, Chennai, India.
Manuscript received
June 19, 2013;
accepted July 9, 2013.
Journal of the American College of Cardiology Vol. 62, No. 25, 2013� 2013 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jacc.2013.07.109
IMAGES IN CARDIOLOGY
A Rare Association of Cor Triatriatum SinisterWith Congenitally Corrected Transpositionof Great ArteriesJebaraj Rathina Samy, MD, Manokar Panchanatham, MD, DM,
Murthy Jayanti Sathya Narayana, MD, DNB, Thanikachalam Sadagopan, MD, DM, DSC
Chennai, India
32-year-old male was evaluated during a general health checkup. Clinical examination and
Atransthoracic echocardiography revealed situs inversus with mesocardia. The details of
intracardiac anatomy could not be obtained due to restricted echo windows. He underwent
cardiacmagnetic resonance imaging for comprehensive evaluation. Evaluation showed situs inversus,
mesocardia, congenitally corrected transposition of great arteries (CCTGA), and cor triatriatum
sinister (A toC, Online Video 1) withmoderate pulmonary hypertension. There was a peak gradient
of 1.5 m/s on velocity encoded through plane imaging of the restrictive orifice of cor triatriatum
(D to G, Online Video 2). It is well known that an additional abnormality causing higher
morphological left ventricular pressure improves tricuspid regurgitation and symptoms in CCTGA.
In this patient, the clinical management dilemma is because the obstructed cor triatriatum
(C and E, arrowheads) is probably maintaining the higher morphological left ventricular pressure.
