PMC4782468_01
Two-dimensional (a) and two-dimensional color flow Doppler (b) echocardiography images from the sub-costal window. (a) The cor-triatriatum dexter membrane (arrows) that separates the right atrium into two parts. The inner part of right atrium receives the systemic venous blood from superior vena cava and inferior vena cava which is directed by the cor-triatriatum membrane to the left atrium via the foramen ovale. (b) The right to left shunt (blue color) across the foramen ovale. RA: Right atrium, SVC: Superior vena cava, IVC: Inferior vena cava, LA: Left atrium, FO: Foramen ovale
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F1
Both blood flow from IVC and superior vena cava (SVC) were directed by this membrane to the left atrium (LA) via a stretched patent foramen ovale (PFO) [Figure 1].
Two-dimensional (a) and two-dimensional color flow Doppler (b) echocardiography images in four chamber views from the apical window. (a) The cor-triatriatum dexter membrane (arrows) which is partially prolapsing across the tricuspid valve to the right ventricle during diastole. (b) Eccentric tricuspid valve inflow (red color) from the outer part of the right atrium to right ventricle. The blue color represents the systemic venous blood flow that is diverted back to right atrium by the cor-triatriatum dexter membrane. LA: Left atrium, LV: Left ventricle, RA: Right atrium, RV: Right ventricle
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F2
TV toward the right ventricle (RV) with no significant inflow gradient across TV [Figure 2]. The rest of the detailed echocardiography study did not reveal any other intra- or extra-cardiac abnormal findings and showed a good biventricular systolic function.
A demonstrates a two-dimensional echocardiography image from sub-costal window (a) after the surgical resection of the the cor-triatriatum dexter membrane and patch closure of the atrial septal defect. (b) A piece of the the cor-triatriatum dexter membrane. IVC: Inferior vena cava, LA: Left atrium, RA: Right atrium, and SVC: Superior vena cava
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F3
Her subsequent follow-up showed no residual membrane and there was laminar IVC and SVC flow across TV into a normal sized RV [Figure 3].