The diagnostic value and misdiagnostic analysis of cor triatriatum sinistrum in children by Doppler echocardiography

LU Xiuli; LIU Yiman; CHEN Lijun; ZHANG Yuqi; ZHAO Linlin

Abstract：Objective To investigate the diagnostic value of color Doppler echocardiography for cor triatriatum sinistrum(CTS)in children,and analyze the misdiagnosed reason to improve the correct rate of diagnosis in the future.Methods Thirty-six children with CTS diagnosed by echocardiography were retrospectively to,echocardiographic images were compared with sur-gical findings in 26 patients.Results Among the 26 CTS confirmed by surgical operation,2 cases were the simple CTS,19 cases were associated malformations included atrial septal defect,6 cases were mild-to-moderate tricuspid valve regurgitation,16 cases were pulmonary hypertension,3 cases were patent foramen ovale,3 cases were ventricular septal defect,and 3 cases were partial anomalous pulmonary venous connection.Two-dimensional echocardiography shows showed abnormal membrane-like tis-sue in the left atrium in the subcostal sagittal view of the atrium septum,apical four-chamber view,and parasternal long-axis view of the left ventricle,color Doppler echocardiography revealed color flow signals through membranel-like tissue from the ac-cessory chamber to the true left atrium.In 26 operated children,24 cases were diagnosed correctly,1 case was misdiagnosed as coumadin ridge,1 case was missed.The abnormal membrane-like tissue was resected in 26 children,the maximum velocity origi-nating proxinal to membrane decreased from(2.15±0.43)m/s to(0.85±0.22)m/s(P＜0.05).In 10 children with unoperated CTS followed up more than 2 years,there was no significant increase in flow velocity through membrane-like tissue,and the flow velocities were all less than 1.6 m/s(P＞0.05).Conclusions CTS could be diagnosed accurately by Color Doppler echocardiog-raphy,but it is prone to be missed and misdiagnosed,and needs to be differentiated from congenital supravalvular mitral ring and coumadin ridge.The outcome of surgical correction of the CTS is good.