Cor triatriatum surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [5]

Overview

In cor triatriatum, adminstration of effective surgical therapy in a timely manner can greatly impact the patient's prognosis. Considerations must made to evaluate to utilize the most appropriate surgical approach, right atrial or left atrial.

Surgical Therapy

  • The role of percutaneous balloon dilation in managing this condition remains to be determined.
  • It can be treated surgically by removing the membrane dividing the atrium.

Left atrial approach

  • Better if the patient is older, and defect is larger
  • Excise the obstructing diaphragm
  • Enlarge the left atrium as needed and close the interatrial connection

Right atrial approach

Better if the patient is younger, and defect is smaller

  • Locate the diaphragm through the ASD
  • Excise the obstructing diaphragm
  • Close the ASD

2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[1]

Therapeutic Recommendations for Cor Triatriatum

Class I
1. In patients presenting with acute chest pain and suspected ACS, clinical decision pathways (CDPs) should categorize patients into low-, intermediate-, and high-risk strata to facilitate disposition and subsequent diagnostic evaluation.(Level of Evidence: B-NR)

References

  1. Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM; et al. (2019). "2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". J Am Coll Cardiol. 73 (12): 1494–1563. doi:10.1016/j.jacc.2018.08.1028. PMID 30121240.


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