斎藤 誠¹, 小竹 寛¹, 長谷川 純一¹, 山崎 純一¹, 都田 裕之¹, 真柴 裕人¹, 谷口 巖², 佐々木 成一朗², 森 透²

Makoto SAITOH¹, Hiroshi KOTAKE¹, Jun-ichi HASEGAWA¹, Jun-ichi YAMASAKI¹, Hiroyuki MIYAKODA¹, Hiroto MASHIBA¹, Iwao TANIGUCHI², Sei-ichiro SASAKI², Toru MORI²

¹鳥取大学医学部第1内科, ²鳥取大学医学部第2外科

¹The First Department of Iiternal Medicine, Tottori University School of Medicine, ²The Second Department of Surgery, Tottori University School of Medicine

キーワード : Cor triatrum, Color Doppler echocardiography, Transesophageal two-dimensional echocardiography, Inflow signal

A 45-year-old female with cor triatriatum was reported with special reference to the inflow signals passing from the accessory chamber to the left atrium using color Doppler echocardiography. Transthoracic and transesophageal 2-dimensional echocardiography (2-D echo) revealed a bright, echodense septum between the inter-atrial septum and the left atrial wall. However, a fenestration within this abnormal septum could not be visualized by 2-D echo. Transthoracic color Doppler echocardiography showed only the one inflow signal in short axis view, but transesophageal color Doppler echocardiography showed the two inflow signals. During surgery we found a spiral-shaped septum originating from the posterior wall of the left atrium and no fenestration within the septum. A fenestration of about 1 cm in diameter was composed of the abnormal septum and the posterior wall of the left atrium. The three inflow signals detected by color Doppler echocardiography were believed to show the abnormal intra-atrial hemodynamic patterns caused by the complex structure of the left atrium. Transesophageal 2-D echo color Doppler echocardiography proved to be useful in detecting the complex structures and the hemodynamic patterns in our case of cor triatriatum.