Divided left atrium: Operative results and follow-up in the cor triatriatum

Objectives. A divided left atrium because of cor triatriatum is a relativel y rare cardiac anomaly requiring corrective surgery. We describe here our c linical and surgical experience with this congenital heart defect as well a s the different medium and long term diagnostic, surgical and evolution asp ects. Patients and methods. From 1981 to 1999, 15 children with cor triatriatum w ithout complex associated cardiovascular defects underwent surgery at a mea n age of 13 months (excision of the obstructive membrane). The surgical rep orts were reviewed and the clinical and echocardiographic data were analyze d before and after the intervention; six of these patients (40%) were refer red to operating room only with the 2-D echo Doppler technique and color fl ow mapping information. The follow-up period ranged from 8 months to 19.3 y ears. Results. Diagnosis was confirmed during the surgical procedure. One 9 month old patient died 60 days after a successful corrective surgery because of sepsis (7%). No late deaths or reoperations were found in the follow-up per iod. All 14 patientes who survived the operation have a functional class 1 (NYHA), and they are asymptomatic in the follow-up. The overall survival ra te was 93% (70% Cl: 87-90). Conclusions. Corrective surgery with excision of the obstructive membrane d ividing the left atrium restores normal anatomic, hemodynamic and clinical status in children with cor triatriatum without complex associated defects.