{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T02:20:01Z","timestamp":1762050001854,"version":"build-2065373602"},"reference-count":12,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Cor triatriatum dexter (CTD) is an extremely uncommon and underreported congenital cardiac anomaly in which the persistence of the embryonic right venous valve separates the right atrium into two chambers with varying degrees of obstruction to antegrade flow and variable degree of right to left shunt at atrial level. Depending on the size of the valves, clinical manifestations vary from absence of symptoms to severe hypoxia, requiring urgent surgical correction. We herein describe the diagnostic difficulties in a case of neonatal CTD, who developed increasingly severe and unresponsive cyanosis, first interpreted as postnatal maladjustment with pulmonary hypertension. The failure to respond to oxygen and pulmonary vasodilators led us to reconsider a different diagnosis. The use of contrast echocardiography improved the diagnostic performance of transthoracic echocardiogram (TTE) and revealed a massive right-to-left shunt secondary to the presence of an atrial membrane that required urgent surgery.<\/jats:p>","DOI":"10.3390\/children9050676","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T14:49:38Z","timestamp":1651848578000},"page":"676","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cor Triatriatum Dexter: Contrast Echocardiography Is Key to the Diagnosis of a Rare but Treatable Cause of Neonatal Persistent Cyanosis"],"prefix":"10.3390","volume":"9","author":[{"given":"Irene","family":"Picciolli","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8251-5013","authenticated-orcid":false,"given":"Gaia","family":"Francescato","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Maria","family":"Colli","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Cappelleri","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Mayer","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5917-0600","authenticated-orcid":false,"given":"Roberto","family":"Raschetti","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Di Cosola","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Pisaniello","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe Alberto","family":"Annoni","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Papa","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mimoza","family":"Maldi","sequence":"additional","affiliation":[{"name":"Congenital Cardiac Surgery, ASST Grande Ospedale Metropolitano Niguarda, 20126 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7597-5492","authenticated-orcid":false,"given":"Guido","family":"Olivieri","sequence":"additional","affiliation":[{"name":"Congenital Cardiac Surgery, ASST Grande Ospedale Metropolitano Niguarda, 20126 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Mosca","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Marianeschi","sequence":"additional","affiliation":[{"name":"Congenital Cardiac Surgery, ASST Grande Ospedale Metropolitano Niguarda, 20126 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.xjtc.2020.09.005","article-title":"Commentary: Cor triatriatum dexter: A tale of 2 horns","volume":"4","author":"Said","year":"2020","journal-title":"JTCVS Tech."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.xjtc.2020.08.024","article-title":"Cor 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Med."},{"key":"ref_4","first-page":"e6371","article-title":"A Systematic Review of a Long-forgotten Cause of Atrial Fibrillation and Stroke: Cor Triatriatum","volume":"11","author":"Ullah","year":"2019","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1136\/heartjnl-2020-316662","article-title":"Contrast echocardiography: Current status and future directions","volume":"107","author":"Lindner","year":"2020","journal-title":"Heart"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1007\/s00247-021-05119-3","article-title":"Contrast-enhanced ultrasound in pediatric echocardiography","volume":"51","author":"Kutty","year":"2021","journal-title":"Pediatric Radiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s00059-017-4533-x","article-title":"Contrast echocardiography in daily clinical practice","volume":"42","author":"Eskandari","year":"2017","journal-title":"Herz"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1111\/j.1540-8175.2008.00777.x","article-title":"Diagnosis of a very rare variant of cor triatriatum dexter by contrast echocardiography: A case report","volume":"26","author":"Modi","year":"2009","journal-title":"Echocardiography"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1111\/echo.14142","article-title":"Agitated saline contrast echocardiography reveals cor triatriatum dexter","volume":"35","author":"Theodoropoulos","year":"2018","journal-title":"Echocardiography"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4267","DOI":"10.1111\/jocs.15896","article-title":"Surgical management of divided atrial chambers","volume":"36","author":"Sankhyan","year":"2021","journal-title":"J. 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