J Cardiovasc Imaging.  2018 Jun;26(2):103-105. 10.4250/jcvi.2018.26.e5.

A Case of Unroofed Coronary Sinus with Coronary Sinus Orifice Atresia: Use of Multimodality Imaging

• Kim SJ
• Ann SH
• Kim YG
• Park GM
• Won KB
• Lee SG

• KMID: 2415460
• DOI: http://doi.org/10.4250/jcvi.2018.26.e5

Abstract

No abstract available.

MeSH Terms

Coronary Sinus*

Figure

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  Figure 1 Transthoracic echocardiography revealed mitral stenosis and unroofed coronary sinus. (A) Doming of the anterior mitral leaflet and limited motion of the posterior mitral leaflet were demonstrated. (B) In the apical 4-chamber view with tilting, a huge dilated CS was identified. (C) With counterclockwise rotation of the probe, a 22-mm large defect between the dilated CS and the LA was detected. (D) Agitated saline was injected via the left antecubital vein. On contrast echocardiography, the RA was filled with air bubbles, but not the dilated CS, and then the right ventricle was filled with air bubbles later. This finding showed no persistent left superior vena cava. There was no negative jet in the RA, which raised the possibility of CS orifice atresia. CS: coronary sinus, LA: left atrium, LV: left ventricle, RA: right atrium, RV: right ventricle.

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  Figure 2 Computed tomography. (A) On computed tomography imaging, there was no persistent left superior vena cava (arrow). (B) A huge dilated CS was observed, showing no communication with the RA, which suggested CS orifice atresia. Ao: aorta, CS: coronary sinus, LV: left ventricle, RA: right atrium.

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  Figure 3 Three-dimensional echocardiography. (A) In the en face view of the LA, an ovoid-shaped defect (asterisk) was found between the CS and the LA, posterior to the mitral valve. (B) After horizontal rotation of the image, the bottom of the CS and the blinded pouch were visible through the defect. No communication between the CS and the right atrium was visible, which suggested CS orifice atresia. CS: coronary sinus, LA: left atrium.

Reference

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