Horike K, Matsumura C, Egawa Y, Kirino A, Ohshio T, Kawahito T, Miyauchi T, Ishibashi H, Ohta A, Akita H
Department of Surgery, Kagawa National Children's Hospital, Zentsuji, Japan.
Kyobu Geka. 1993 Nov;46(12):1063-5.
Cor triatriatum is uncommon in all congenital heart diseases. It is a malformation resulting in a separation of the left atrium or right atrium into two chambers due to a congenitally abnormal diaphragm. We wish to present a case of cor triatriatum in which MRI was found most useful for preoperative diagnosis and surgical procedure. A 2-year-old girl was transferred to us for severe pulmonary congestion as shown on chest X-ray. Echocardiography showed abnormal diaphragm in the left atrium. MRI demonstrated clearly the relationship between left pulmonary vein and the abnormal diaphragm. Therefore we should preoperatively determine type I A according to the Lucas and Schmidt's classification. Cardiac catheterization showed moderate pulmonary hypertension and confirmed cor triatriatum. The resection of the abnormal diaphragm was performed under extracorporeal circulation with moderate hypothermia. The postoperative course was uneventful. MRI is a very useful non-invasive technique in making a diagnosis and in choosing the appropriate surgical procedure for cor triatriatum.
三房心在所有先天性心脏病中都不常见。它是一种由于先天性异常隔膜导致左心房或右心房分隔为两个腔室的畸形。我们希望呈现一例三房心病例，其中发现MRI对术前诊断和手术操作最为有用。一名2岁女孩因胸部X线显示的严重肺淤血被转诊至我院。超声心动图显示左心房存在异常隔膜。MRI清晰地显示了左肺静脉与异常隔膜之间的关系。因此，我们应根据卢卡斯和施密特的分类在术前确定为IA型。心导管检查显示中度肺动脉高压并确诊为三房心。在中度低温体外循环下进行了异常隔膜切除术。术后过程顺利。MRI是诊断三房心并选择合适手术操作的一种非常有用的非侵入性技术。
