Successfully repaired adult cor triatriatum with mitral regurgitation and atrial fibrillation: a case report.

Abstract

Background: Rarely seen in adults, cor triatriatum is a congenital defect in which a membrane creates three atrial chambers in the heart. Atrial fibrillation (AF) is the most common complication, but repair procedures in adults remain unestablished.

Case presentation: A 49-year-old woman had cor triatriatum sinister (Lucas-Schmidt classification type I-A) with moderate mitral regurgitation and atrial fibrillation. Communication between the accessory chamber and the main chamber was established via a 10-mm fenestration with a pressure gradient of 14 mmHg. Mitral valve repair and the maze procedure, via radiofrequency ablation, was done after complete resection of the anomalous septum in the left atrium. Mitral regurgitation was well-controlled and atrial fibrillation disappeared. Sinus rhythm has been continually maintained at 6 months post-surgery, with no mitral regurgitation recurrence.

Conclusions: Here, a rare adult cor triatriatum case with simultaneous mitral valve regurgitation and atrial fibrillation was treated with good results. The maze procedure shows effectiveness for atrial fibrillation associated with cor triatriatum. Especially the anomalous membrane attachments must be resolved in addition to the conventional maze procedure because electrical mapping of Cor triatriatum sinister showed low-voltage zones at the membrane attachments and it cause macro-reentrant atrial tachycardia.