Cor Vasa 2020, 62(5):513-516 | DOI: 10.33678/cor.2020.002

Isolated Unroofed Coronary Sinus without Persistent Left Superior Vena Cava

Tomáš Toporcera, Ján Luczya, Miroslav Gburb, Gabriel Valočíkb, Adrián Kolesára, František Sabola
a Department of Heart Surgery, Medical Faculty, Pavol Jozef Šafárik University and the Eastern Slovak Institute for Cardiovascular Diseases Ltd., Košice, Slovakia
b Department of Cardiology, Medical Faculty, Pavol Jozef Šafárik University and the Eastern Slovak Institute for Cardiovascular Diseases Ltd., Košice, Slovakia

Unroofed coronary sinus (UCS) represents the rarest type of atrial septal defect, with incidence less than 1% of all atrial septal defects, or less than 0.1% of all congenital heart anomalies. A case report of a 57-year-old man with four years of misdiagnosed UCS is presented. The patient showed dyspnoea, angina pectoris, and a new onset of atrial fibrillation. The diagnosis of UCS was finally established on the basis of right-sided cardiac catheterization, echocardiography, and computer tomography. Defect roofing with redirection of the coronary sinus into the left atrium was performed. UCS is in 75% of cases associated with other heart anomalies, especially persistent left superior vena cava. For isolated UCS, closing via the path from the side of right atrium is sufficient therapy with good long-term results. Persistence of left superior vena cava requires a technically serious occlusion of the defect from the left atrium or a redirection of the persistent vein itself.

Keywords: Atrial septal defect, Echocardiography, Heart surgery, Unroofed coronary sinus

Received: November 3, 2019; Revised: January 7, 2020; Accepted: January 8, 2020; Published: November 1, 2020  Show citation

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Toporcer T, Luczy J, Gbur M, Valočík G, Kolesár A, Sabol F. Isolated Unroofed Coronary Sinus without Persistent Left Superior Vena Cava. Cor Vasa. 2020;62(5):513-516. doi: 10.33678/cor.2020.002.
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References

  1. Toporcer T, Kolesár A, Ledecký L, et al. Late infective endocarditis of an Amplatzer atrial septal device twelve years after implantation. Cor Vasa 2018;60:e174-e178. Go to original source...
  2. Xie MX, Yang YL, Cheng TO, et al. Coronary sinus septal defect (unroofed coronary sinus): echocardiographic diagnosis and surgical treatment. Int J Cardiol 2013;168:1258-1263. Go to original source... Go to PubMed...
  3. Naqvi N, McCarthy KP, Ho SY Anatomy of the atrial septum and interatrial communications. J Thorac Dis 2018;10:S2837-S2847. Go to original source... Go to PubMed...
  4. Chen C, Xu L, Xu Y, et al. Unroofed Coronary Sinus Syndrome: An Easily Corrected Congenital Anomaly But More Diagnostic Suspicion Is Needed. Heart Lung Circ 2018;27:731-738. Go to original source... Go to PubMed...
  5. Quadros SD, Pavithran S, Agrawal R, et al. Coronary sinus atrial septal defect without persistent left superior vena cava: Three-dimensional imaging of a rare defect. Ann Pediatr Cardiol 2018;11:103-105. Go to original source... Go to PubMed...
  6. Bonardi M, Valentini A, Camporotondo R Unroofed coronary sinus and persistent left superior vena cava: A case report. J Ultrasound 2012;15:179-182. Go to original source... Go to PubMed...
  7. Kouchoukos NT, Blackstone EH, Hanley FL, et al. Kirklin/Barratt-Boyes Cardiac Surgery. Philadelphia: Saunders, 2013:2256.
  8. Muthialu N, Fajardo D, Sullivan ID, et al. Repair of Persistent Left Superior Vena Cava to Unroofed Coronary Sinus Defect by Retro-Aortic Implantation (Modified Warden Type Procedure). J Card Surg 2016;31:103-105. Go to original source... Go to PubMed...
  9. Rao PS, Harris AD. Recent advances in managing septal defects: ventricular septal defects and atrioventricular septal defects. F1000Res. 2018;7:F1000 Faculty Rev-498. Go to original source... Go to PubMed...
  10. Zaikokuji K, Sawazaki M, Tomari S, et al. Total endoscopic repair of unroofed coronary sinus syndrome via right mini-thoracotomy. Gen Thorac Cardiovasc Surg 2017;65:206-208. Go to original source... Go to PubMed...
  11. Bozso SJ, Grant A, Iglesias I, et al. Minimally Invasive Periareolar Approach to Unroofed Coronary Sinus Atrial Septal Defect Repair. Ann Thorac Surg 2016;102:e223-e225. Go to original source... Go to PubMed...

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