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Case Reports
. 2019 Jul 24;3(5):189-199.
doi: 10.1016/j.case.2019.05.004. eCollection 2019 Oct.

Forme Fruste Cor Triatriatum Dexter by Transesophageal Echocardiography and Its Impact on Percutaneous Heart Procedures: A Case Series

Benjamin M Gold  1 , Dhaval R Parekh  2   3   4 , Debra L Kearney  5   6 , Guilherme V Silva  2   3   4 , R David Fish  2   3 , Raymond F Stainback  2   3   4
Affiliations
Case Reports

Forme Fruste Cor Triatriatum Dexter by Transesophageal Echocardiography and Its Impact on Percutaneous Heart Procedures: A Case Series

Benjamin M Gold et al. CASE (Phila). .
No abstract available

Keywords: Congenital; Heart defects; Heart septal defects; Heart valve prosthesis implantation; Vascular access devices.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Case 1. Two-dimensional TEE images in the midesophageal four-chamber view. The ff-CTD membrane (arrowhead) is attached to the atrial septum adjacent to the fossa ovalis, producing a telltale Y sign. (A) A small secundum ASD is also shown (arrow). (B) The deployed ASD closure device (arrow). LA, Left atrium; LV, left ventricle.
Figure 2
Figure 2
Case 2. Two-dimensional TEE images in the midesophageal four-chamber view. (A) The ff-CTD membrane (arrowhead) is attached to the atrial septum adjacent to the fossa ovalis, producing a telltale Y sign. (B) PFO closure device with precarious and incomplete deployment (arrow). LA, Left atrium.
Figure 3
Figure 3
Case 3. Two-dimensional TEE images in the midesophageal four-chamber view. (A) The ff-CTD membrane (arrowheads) is attached to the atrial septum adjacent to the fossa ovalis, producing a telltale Y sign. (B) Large secundum ASD detected by 3D TEE (*). Simultaneous orthogonal plane imaging shows malpositioned Amplatzer device within a large secundum ASD in modified (C) four-chamber view and (D) bicaval view. Note the nearly 180° abnormal rotation of the closure device atrial disks, which span the ASD rather than sealing the ASD on both sides. LA, Left atrium; LV, left ventricle.
Figure 4
Figure 4
Case 4. Two-dimensional TEE image (A) in the midesophageal four-chamber view shows the ff-CTD membrane (arrowhead) attached to the atrial septum adjacent to the fossa ovalis, producing a telltale Y sign. (B) TEE 3D views of ff-CTD membrane (arrowhead) using a semi–en face view of the atrial septum and TV annulus modified to best show the defect. LA, Left atrium; LV, left ventricle.
Figure 5
Figure 5
Case 5. Two-dimensional TEE images (A) show the ff-CTD membrane (arrowhead) attached to the atrial septum adjacent to the fossa ovalis, producing a telltale Y sign when the atrial septum is imaged just below the aortic root but above the coronary sinus (low four-chamber view). (B) TEE 3D views of ff-CTD membrane (arrowhead) using a semi–en face view of the atrial septum and TV annulus to best show the defect; black arrow = coronary sinus. AV, Aortic valve LA, left atrium; LV, left ventricle.
Figure 6
Figure 6
Case 6. Two-dimensional TEE image (A) shows the ff-CTD membrane (arrowhead) attached to the atrial septum adjacent to the fossa ovalis, producing a telltale Y sign when the atrial septum is imaged just below the aortic root but above the coronary sinus (low four-chamber view). (B) 3D TEE views of ff-CTD membrane (arrowhead) using a semi–en face view of the atrial septum and TV annulus to best show the defect; black arrow = coronary sinus. AV, Aortic valve LA, left atrium; MVA, MV annuloplasty ring.
Figure 7
Figure 7
Case 7. Two-dimensional TEE images in the midesophageal four-chamber view. (A) The ff-CTD membrane (arrowhead) is attached to the atrial septum adjacent to the fossa ovalis, producing a telltale Y sign. (B) TEE in a bicaval view shows PFO closure device with precarious and incomplete deployment (arrow). LA, left atrium; LV, left ventricle.
Figure 8
Figure 8
Case 8. TEE images. (A) The ff-CTD membrane (arrowhead) attached to the atrial septum adjacent to the fossa ovalis, producing a telltale Y sign by 2D TEE. (B) TEE 3D view of the ff-CTD membrane (arrowhead) using a semi–en face view of the atrial septum and TV annulus to best show the defect. LA, Left atrium; LV, left ventricle.
Figure 9
Figure 9
Case 9. Prominent EV (white arrows). (A) 2D TEE in midesophageal bicaval view, showing the IVC, SVC, RA, left atrium (LA), TV, and aortic valve (AV). (B) 2D TEE modified short-axis view of AV angulated toward the IVC and TV to show prominent EV (arrow), which terminates before the atrial septum. (C) 3D TEE image showing prominent EV, Eustachian ridge (black arrow), and coronary sinus. The Eustachian ridge extends to the inferior margin of the interatrial septum; the EV does not.
Figure 10
Figure 10
Illustration of modified 3D TEE reconstruction cut plane that is not a “standard” direct en face view of the interatrial septum but a modified view to better illustrate the relationship between the atrial septum and fossa ovalis (*) of either a prominent EV (small arrow) or the ff-CTD membrane illustrated in the inserted drawing (arrowhead), which extends onto the atrial septum and creates the Y sign on planar images. AV, Aortic valve; LA, left atrium.
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