Publish in this journal
Journal Information
Vol. 72. Issue 4.
Pages 341 (April 2019)
Share
Share
Download PDF
More article options
Vol. 72. Issue 4.
Pages 341 (April 2019)
Image in cardiology
Full text access
Abnormal Pulmonary Venous Drainage With Cor Triatriatum
Drenaje venoso pulmonar anómalo con cor triatriatum
Visits
...
Manuel Ojeda Ramos
Corresponding author
manueltojeda@gmail.com

Corresponding author:
, David Viladés Medel, Rubén Leta Petracca
Sección de Imagen, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Article information
Full Text
Download PDF
Statistics
Figures (3)
Show moreShow less
Additional material (2)
Full Text

A 27-year-old woman was seen for progressive dyspnea with onset 1 month earlier. Initially, computed tomography angiography of the pulmonary arteries ruled out pulmonary thromboembolism, although marked dilatation of the right ventricle (RV) and the pulmonary artery trunk (PAT) was detected. Likewise, persistence of the left anterior cardinal vein (LACV) was observed, with outflow in the roof of the left atrium (LA) and cranially in the innominate vein (IV). The LACV collected venous drainage from the left lung, while the right pulmonary veins drained with independent ostia into the LA (Figure 1). Echocardiography and cardiac magnetic resonance revealed a left atrial membrane, with limited fenestration, consistent with cor triatriatum (Figure 2). Cardiac magnetic resonance showed LV dilatation (end-diastolic volume index of 188mL/m2), RV ejection fraction of 55%, and a left-right shunt with QP/QS of 4.3:1. The 4D flow sequence showed complete anomalous venous drainage of the left lung and anatomically normal but functionally mixed right venous drainage: cardiac and towards the LACV (Figure 3 and Video 1 of the supplementary material).

Figure 1
(0.13MB).
Figure 2
(0.12MB).
Figure 3
(0.11MB).

Cor triatriatum and LACV rarely co-occur, as the usual presentation is with an atrial shunt. In this case, the use of 4D flow helped to elucidate how the presence of cor triatriatum transformed normal right pulmonary drainage into partially anomalous drainage and confirmed the occurrence of complete left pulmonary drainage toward the LCAV, thus explaining the substantial left-right shunt.

Copyright © 2018. Sociedad Española de Cardiología
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?