AUTHOR=Chen Ping-Hong , Liu Yi-Ching , Dai Zen-Kong , Chen I-Chen , Lo Shih-Hsing , Wu Jiunn-Ren , Wu Yen-Hsien , Hsu Jong-Hau 

TITLE=A Rare Complication During Transcatheter Closure of Double Atrial Septal Defects With Incomplete Cor Triatriatum Dexter: A Case Report

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.815312

DOI=10.3389/fcvm.2021.815312

ISSN=2297-055X

ABSTRACT=The cor triatiatum dexter is an embryologic remnant derived from the right atrium and totally separate the right atrium. The incomplete cor triatiatum dexter(iCTD) means partially obstructive remnant at right atrium. It is usually formed by remnant of Eustachian valve(EV) , Thebesian valve (ThV), or Chiari network(CN). This anatomic variant is usually asymptomatic but often associated with other heart abnormalities including atrial septal defects(ASDs), and has the potential to hamper percutaneous heart procedures such as electrophysiological study or ASD closure. Herein, we report a rare complication, transient heart ischemia, in transcatheter closure of double ASDs in a 55-year-old women with EV. This rare complication was thought to be caused by coronary sinus obstruction during device placement. The ischemic change was resolved spontaneously after we withdrew the device. For a second attempt, we adjusted the position of the device to avoid coronary sinus obstruction under transesophageal echocardiogram guidance and the device was smoothly deployed in good position with minimal residual shunt. This case suggest that anatomy details in percutaneous heart procedures in important and this rare and dangerous complication, heart ischemia, should be identified immediately during the procedure.