https://orcid.org/0000-0002-8433-6198
A 21-year-old female was referred to our department with fever, dyspnoea, and palpitation. She presented cardiogenic shock after pneumonia and was treated by venoarterial-extracorporeal membrane oxygenation for 5 days at local hospital. Computer tomography angiography at admission showed a rare congenital defect of cor triatriatum sinister without other malformations (Panel A, arrow indicates the membrane dividing left atrium into two chambers). Bedside catheterization showed severe pulmonary hypertension (Panel B) with significantly elevated pulmonary capillary wedge pressure (Panel C). Transcatheter balloon dilation was applied as a bridge for further surgical correction due to her extensive infection and hypoxic ischaemic encephalopathy at admission. Left atrium angiography during procedure revealed the contrast retention in accessory chamber that formed a tornado-like vortex before going through the 5 mm orifice close to left atrium roof (Panel D, Supplementary data online, Video S1). A veno-arterial rail was established under fluoroscopy (Panel E) and followed by transoesophageal echocardiography-guided balloon dilation (Panel F, dilation with 25*50 mm balloon, Balt Extrusion, France; arrow indicates the membrane in left atrium, arrowhead indicates the guidewire resting in ascending aorta, Supplementary data online, Video S2). Pulmonary arterial pressure was 65/26 (39) mmHg and pressure of accessory chamber dropped from 50/42 (46) mmHg to 21/12(15) mmHg post-dilation. There were no haemodynamic changes during procedure. Subsequently, the patient underwent successful surgical repairment and was discharged 7 days post-surgery. She recovered well without neurological disorders at 1-month follow-up.
Supplementary data are available at European Heart Journal online.
No data were generated or analysed for or in support of this article.
All authors declare no conflict of interest for this contribution.
Author notes
This work was performed in Zhongnan Hospital of Wuhan University by listed authors.
