Giant remnant of fetal circulation leading to cyanosis: Pseudo-cor triatriatum dexter

• Published in: The Thoracic and Cardiovascular Surgeon
• Main Authors: Yerebakan, C., Elmontaser, H., Valeske, K., Müller, M., Esmaeli, A., Schranz, D., Akintürk, H.
• Format: Conference Proceeding
• Language: English
• Published: 10.02.2014
• ISSN: 0171-6425; 1439-1902
• DOI: 10.1055/s-0034-1367351

Introduction: Cor triatriatum dexter or similar entities with obstructing membrane within the right atrium are very rare anomalies. When the right valve of the sinus venosus fails to regress during the fetal period a divided right atrium ensues instead of leaving her remnants i.e. the Eustachian, Thebesian valves of the inferior vena cava and coronary sinus, respectively. Case presentation: A full-term one-week-old girl was referred to our clinic with the symptom of cyanosis immediately after an uncomplicated birth. She had a peripheral arterial saturation of up to 65% without supplementary oxygen. Transthoracic echocardiography showed situs solitus with enlarged right atrial chamber with leftward deviation of the interatrial septum through which right to left shunting was encountered. A crescent form floppy membrane lead to partial obstruction of the inflow through the tricuspid valve and directed the vena cava inflow passing the defect in the interatrial septum to the left atrium. The patient was operated on cardiopulmonary bypass with mild hypothermia and cardioplegic arrest. The floppy membrane that originated from the Eustachian valve was resected and the atrial septal defect was closed using glutaraldehyde treated autologous pericardium. Her postoperative course was uneventful. Discussion: The term of cor triatriatum dexter is not always an adequate description of the anatomical substrate in the entire spectrum of larger valve of sinus venosus with differing degrees of septation. Surgical repair with resection of the remnant membrane is needed in symptomatic patients.