Cœur triatrial gauche : une cause inhabituelle de détresse respiratoire néonatale

{ "0" : "Cardiologie pédiatrique, hôpital des Enfants, Toulouse" , "1" : "Réanimation pédiatrique, hôpital des Enfants, Toulouse" , "2" : "SAMU pédiatrique, hôpital des Enfants, Toulouse" , "4" : "Œdème aigu pulmonaire" , "5" : "Nouveau-n&eacute" , "6" : "Cardiopathie congénitale" , "7" : "Pulmonary edema" , "8" : "Heart defects, congenital" , "9" : "Infant, newborn"}
Archives de Pédiatrie (Impact Factor: 0.41). 08/2006; 13(8):1129-1131. DOI: 10.1016/j.arcped.2006.04.020


We report the case of a newborn presenting with neonatal respiratory distress due to acute pulmonary edema, the underlying diagnosis being cor triatriatum sinister. This rare anomaly can be lethal in the short term. However, it can be completely cured surgically provided that diagnosis is made on time.

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    ABSTRACT: The principal pathologic findings in 13 cases of classical cor triatriatum were presented, including the first documented case of complete transposition of the great arteries and the fourth reported case of tetralogy of Fallot with cor triatriatum.Findings relevant to this anomaly were reported from a study of normal development of the pulmonary vein and atrial septum, based on 83 human embryos. Attention was focused on the origin, course, and incorporation of the common pulmonary vein and on the origins and development of septum primum, the left venous valve, and the intersepto-valvular space.The pathologic and embryologic findings strongly suggest that cor triatriatum results from entrapment of the left atrial ostium of the common pulmonary vein by tissue of the right horn of the sinus venosus from which septum primum develops, leading to failure of incorporation of the common pulmonary vein into the left atrium during the fifth embryonic week.
    American Heart Journal 10/1969; 78(3):379-405. DOI:10.1016/0002-8703(69)90046-5 · 4.46 Impact Factor
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    ABSTRACT: A case report of a 29-year-old woman with increasing cardiac distress is reported. No murmur could be heard. The heart was not enlarged, but a prominent second left arch and pulmonary congestion were found on the roentgenogram. Moreover, the lower lobe of the left lung was markedly emphysematous. An electrocardiogram showed right ventricular hypertrophy. On heart catheterization, an excessive pulmonary hypertension was found, and the pulmonary “capillary pressure”, too, was very high. A mitral disease, therefore, was suggested, and the patient submitted to surgery. Thoracotomy revealed a normal mitral valve, and a normal pressure in the left atrium was measured directly. At post mortem the findings were fully explained, as a transverse septum with only one small perforation was separating the opening of the pulmonary veins from the rest of the atrium (so-called cor triatriatum).A review is made of the literature concerning anomalous, congenital structures within the left atrium. Thin cords or even broad bands across the lumen have been of no significance. The real cor triatriatum, however, was a serious disorder. Many of the patients died shortly after birth, and only a few reached the adult age. The clinical symptoms and signs were by no means characteristic, and no help was obtained from the usually employed investigations. An in-vivo diagnosis, therefore, must certainly be left for an explorative thoracotomy. The possibility of an effective surgical treatment is briefly discussed.
    American Heart Journal 06/1954; 47(5-47):676-691. DOI:10.1016/0002-8703(54)90192-1 · 4.46 Impact Factor
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    ABSTRACT: An 8-year-old girl was referred for evaluation of a heart murmur and progressive dyspnea with exertion. Transthoracic echocardiogram revealed Cor triatriatum with severe stenosis at its orifice. The resting transmembrane CW Doppler velocity was 2.3 m/sec. Cardiac catheterization and hemodynamic assessment were performed and demonstrated a marked increase in pulmonary capillary wedge and pulmonary artery pressures. The stenosis was successfully dilated with an Inoue balloon using a transseptal technique. This is the first description of dilation of a Cor triatriatum using the Inoue technique. Only one previous case report of balloon dilatation for Cor triatriatum sinister has appeared in the English literature using a different technique (double balloon method).
    Catheterization and Cardiovascular Interventions 10/2002; 57(2):252-6. DOI:10.1002/ccd.10334 · 2.11 Impact Factor