Ostman-Smith I, Silverman N H, Oldershaw P, Lincoln C, Shinebourne E A
Br Heart J. 1984 Feb;51(2):211-9. doi: 10.1136/hrt.51.2.211.
M mode and cross sectional echocardiography was carried out in three cases of cor triatriatum sinistrum (two infants and one adult). In two cases a peculiar double arch appearance, not previously reported, was found. All three cases were referred for surgery without cardiac catheterisation, and the diagnosis proved to be correct. The characteristic echocardiographic feature of cor triatriatum is an intra-atrial membrane detected in multiple planes of examination, curving anteroinferiorly and inserting some distance away from the mitral valve ring, proximal to the left atrial appendage. Superiorly the membrane runs parallel to, and a short distance behind, the aortic root creating a superior recess of the distal left atrial chamber. These features differentiate cor triatriatum from a supravalvar mitral ring. During diastole the membrane moves forward towards the mitral valve funnel. This, together with the arching appearance of the membrane on four chamber views and the more superior position of the membrane, makes it possible to distinguish cor triatriatum from total anomalous pulmonary venous drainage to the coronary sinus. From a review of past experience at the Brompton Hospital of the diagnostic accuracy of cardiac catheterisation in this condition, it is concluded that cross sectional echocardiography is superior to angiography as a technique for diagnosing cor triatriatum.
对3例左房三房心患者（2例婴儿和1例成人）进行了M型和横断面超声心动图检查。其中2例发现了一种此前未报道过的特殊双弓表现。所有3例患者未经心导管检查即被转诊接受手术，诊断结果证明是正确的。三房心的特征性超声心动图表现是在多个检查平面中检测到的心房内隔膜，隔膜向前下弯曲，插入点距离二尖瓣环一定距离，位于左心耳近端。隔膜上方与主动脉根部平行，且在主动脉根部后方有一小段距离，形成左房远心腔的上隐窝。这些特征可将三房心与二尖瓣上环形结构区分开来。在舒张期，隔膜朝着二尖瓣漏斗向前移动。这一点，再加上四腔心切面中隔膜的拱形外观以及隔膜更靠上的位置，使得三房心能够与完全性肺静脉异位引流至冠状窦相鉴别。回顾过去在布朗普顿医院对这种疾病进行心导管检查的诊断准确性经验，得出结论：作为诊断三房心的技术，横断面超声心动图优于血管造影。
