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Włodarczak S, Rola P, Jastrzębski A, Barycki M, Kędzierska M, Korda A, Włodarczak A, Lesiak M. Implantation of a coronary sinus reducer for refractory angina due to coronary microvascular dysfunction. Kardiol Pol 2023; 82:103-104. [PMID: 37997839 DOI: 10.33963/v.kp.98104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023]
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Kanzaki Y, Morishima I, Miyazawa H, Shimojo K. Antidromic and orthodromic reciprocating tachycardias over a novel left-sided accessory pathway involving the vein of Marshall and coronary sinus musculature. J Cardiovasc Electrophysiol 2023; 34:2398-2402. [PMID: 37727933 DOI: 10.1111/jce.16075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/10/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Herein, we present a rare case of the successful ablation of an accessory pathway (AP) involving the Marshall Bundle (MB) and coronary sinus musculature (CSM) in a 40-year-old man with Wolff-Parkinson-White syndrome. METHODS AND RESULTS An orthodromic reciprocating tachycardia (ORT) was inducible with the earliest atrial activation site located at the posterolateral mitral annulus. The local conduction and the cycle length of ORT was prolonged by peri-mitral ablation; however, it failed to block the AP. The atrial insertion of the AP was identified by remapping during ORT at the left atrial ridge, which was away from the mitral annulus, where ablation was successful. Together with the electrophysiological findings in CSM potentials, we conclude that the epicardial MB-CSM connection functioned as the AP in this patient. CONCLUSION The novel variant form of AP comprised of MB and CSM should be noted. The atrial insertion of the MB may be the target of catheter ablation.
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Reddy RK, Foley M, Giannini F, Al‐Lamee RK. Keeping it in the family: Use of the grandmother, mother, and child technique to navigate complex anatomy during Coronary sinus Reducer Implantation. Catheter Cardiovasc Interv 2023; 102:1057-1060. [PMID: 37937675 PMCID: PMC10952940 DOI: 10.1002/ccd.30858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/19/2023] [Accepted: 10/05/2023] [Indexed: 11/09/2023]
Abstract
The Coronary Sinus Reducer® (CSR) is an emerging therapy for refractory angina recommended once no further pharmacologic or coronary revascularization options are available. We present the case of a 72-year-old man who underwent CSR implantation. Complex coronary sinus anatomy necessitated an innovative "grandmother, mother, and child" catheter approach.
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Torun EG, Koca S, Dinçel GK, Çay S. Successful catheter ablation of the accessory pathway in an unusual location in a 13-year-old girl with a coronary sinus diverticulum and Wolff-Parkinson-White syndrome. Cardiol Young 2023; 33:2375-2378. [PMID: 37144400 DOI: 10.1017/s1047951123001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Wolff-Parkinson-White syndrome is a congenital cardiac pre-excitation syndrome that is effectively treated by ablating the accessory pathway. However, accessory pathways located in the posteroseptal region can sometimes be challenging. In this paper, we present the successful ablation of the epicardial posteroseptal accessory pathway through the middle cardiac vein in a 13-year-old girl with a coronary sinus diverticulum and Wolff-Parkinson-White syndrome, after unsuccessful ablation attempts at different locations. If the ablation procedure fails, the possibility of the posteroseptal pathway should be kept in mind, and coronary sinus angiography should be performed. In cases with a coronary sinus diverticulum where ablation is not successful, other coronary sinus structures, for example, the middle cardiac vein should be considered as potential accessory pathways.
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Sasaki N, Sanders SP, Geva T, Ghelani SJ. Coronary Sinus Aneurysm With a Sinoventricular Valve. Circ Cardiovasc Imaging 2023; 16:e015513. [PMID: 37869891 DOI: 10.1161/circimaging.123.015513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
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Karmegaraj B. Whale's tail sign in fetus with coronary sinus total anomalous pulmonary venous connection. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 62:761-764. [PMID: 37329505 DOI: 10.1002/uog.26294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/30/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
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Wojtowicz A, Zaluska-Pitak B, Juszczak M, Huras H, Goreczny S. Prenatal diagnosis of isolated total anomalous pulmonary venous connection (TAPVC) to coronary sinus. Ginekol Pol 2023; 95:318-319. [PMID: 37842991 DOI: 10.5603/gpl.96430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023] Open
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Joshi S, Singh A. Absent right superior vena cava and persistent left superior vena cava: An incidental finding. Ann Card Anaesth 2023; 26:433-434. [PMID: 37861579 PMCID: PMC10691572 DOI: 10.4103/aca.aca_91_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 10/21/2023] Open
Abstract
A patient with Marfan syndrome undergoing Bentall operation was found to have an absent right superior vena cava and persistent left superior vena cava. The dilation of coronary sinus raised the suspicion of persistent left superior vena cava. The diagnosis was confirmed by agitated saline contrast echocardiography and computed tomography of the chest.
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Tsiachris D, Giannini F, Antoniou CK, Dimitriadis K, Stefanadis C, Tsioufis K. First-in-man parallel implantation of a coronary sinus Reducer and biventricular pacemaker. J Cardiovasc Med (Hagerstown) 2023; 24:778-780. [PMID: 37577865 DOI: 10.2459/jcm.0000000000001529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
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Mangel T, Divya A, De Silva R. Management of anomalous origin of right coronary artery from left coronary sinus. J Cardiothorac Surg 2023; 18:264. [PMID: 37752517 PMCID: PMC10521490 DOI: 10.1186/s13019-023-02354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/09/2023] [Indexed: 09/28/2023] Open
Abstract
Aberrant origin of coronary artery is a rare congenital anomaly associated with increased risk of myocardial ischemia and sudden death, with the highest risk lesions being those arising from the opposite sinus of Valsalva. We report a case with an aberrant right coronary artery arising superior to the left coronary cusp, with a slit-like ostium, having an inter-arterial and intramural course through the aortic root, that underwent repositioning of the right coronary artery. We believe such cases warrant surgical correction and reimplantation is a safe, effective and reproducible technique.
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Jacon P, Venier S, Carabelli A, Rees T, Maigron M, Peter P, Deschamps E, Desbiolles A, Ndiaye M, Defaye P. Posteroseptal Accessory Pathway Ablation Via a Left Superior Vena Cava and Retrograde Coronary Sinus Approach. JACC Clin Electrophysiol 2023; 9:1428-1432. [PMID: 37086225 DOI: 10.1016/j.jacep.2023.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/29/2022] [Accepted: 01/29/2023] [Indexed: 04/23/2023]
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Selcuk A, Korun O, Sasmazel A. Persistent left superior vena cava draining into the unroofed coronary sinus in a patient with tetralogy of Fallot and coronary sinus orifice atresia. Cardiol Young 2023; 33:1199-1200. [PMID: 36408642 DOI: 10.1017/s1047951122003638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION In this study, we present a case of directing persistent left superior vena cava drainage into the unroofed coronary sinus to the right atrium in a patient with tetralogy of Fallot and coronary sinus orifice atresia without innominate vein. CASE REPORT A 16-month-old boy diagnosed with tetralogy of Fallot was admitted. Following intracardiac repair, the left superior vena cava was divided from the left atrial junction, passed through under the ascending aorta and anastomosed to the right superior vena cava. CONCLUSION To our knowledge, this is the first patient reported with persistent left superior vena cava, unroofed coronary sinus, coronary sinus orifice atresia, and tetralogy of Fallot. The extracardiac direct anastomosis technique was used successfully to direct persistent left superior vena cava to the right atrium without any post-procedure complications.
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Irannejad K, Vakhshoori M, Khoubyari R, Movahed MR. Contrast removal from coronary sinus for prevention of contrast-induced nephropathy: a review. Future Cardiol 2023; 19:283-299. [PMID: 37466075 DOI: 10.2217/fca-2023-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
The occurrence of contrast-induced-nephropathy (CIN) is related to the amount of contrast administration. Any removal of contrast from systemic circulation before reaching the kidneys might be beneficial using a device that removes contrast from a coronary sinus (CS). This manuscript aims to review the available literature regarding contrast removal from CS during coronary angiography or intervention for the prevention of CIN.
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Xie J, Chen A, Ma Z, Xu X, Wei X. Intramyocardial dissecting hematoma associated with a coronary sinus diverticulum: a rare cause of chest pain. Intern Emerg Med 2023; 18:667-669. [PMID: 36180614 DOI: 10.1007/s11739-022-03111-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/15/2022] [Indexed: 11/05/2022]
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Tanigaki T, Kato S, Azuma M, Ito M, Horita N, Utsunomiya D. Coronary flow reserve evaluated by phase-contrast cine cardiovascular magnetic resonance imaging of coronary sinus: a meta-analysis. J Cardiovasc Magn Reson 2023; 25:11. [PMID: 36805689 PMCID: PMC9940433 DOI: 10.1186/s12968-023-00912-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/05/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND Phase-contrast cine cardiovascular magnetic resonance (CMR) of the coronary sinus has emerged as a non-invasive method for measuring coronary sinus blood flow and coronary flow reserve (CFR). However, its clinical utility has not yet been established. Here we performed a meta-analysis to clarify the clinical value of CMR-derived CFR in various cardiovascular diseases. METHODS An electronic database search was performed of PubMed, Web of Science Core Collection, Cochrane Advanced Search, and EMBASE. We compared the CMR-derived CFR of various cardiovascular diseases (stable coronary artery disease [CAD], hypertrophic cardiomyopathy [HCM], dilated cardiomyopathy [DCM]) and control subjects. We assessed the prognostic value of CMR-derived CFR for predicting major adverse cardiac events (MACE) in patients with stable CAD. RESULTS A total of 47 eligible studies were identified. The pooled CFR from our meta-analysis was 3.48 (95% confidence interval [CI], 2.98-3.98) in control subjects, 2.50 (95% CI, 2.38-2.61) in stable CAD, 2.01 (95% CI, 1.70-2.32) in cardiomyopathies (HCM and DCM). The meta-analysis showed that CFR was significantly reduced in stable CAD (mean difference [MD] = -1.48; 95% CI, -1.78 to -1.17; p < 0.001; I2 = 0%; p for heterogeneity = 0.33), HCM (MD = -1.20; 95% CI, -1.63 to -0.77; p < 0.001; I2 = 0%; p for heterogeneity = 0.49), and DCM (MD = -1.53; 95% CI, -1.93 to -1.13; p < 0.001; I2 = 0%; p for heterogeneity = 0.45). CMR-derived CFR was an independent predictor of MACE for patients with stable CAD (hazard ratio = 0.52 per unit increase; 95% CI, 0.37-0.73; p < 0.001; I2 = 84%, p for heterogeneity < 0.001). CONCLUSIONS CMR-derived CFR was significantly decreased in cardiovascular diseases, and a decreased CFR was associated with a higher occurrence of MACE in patients with stable CAD. These results suggest that CMR-derived CFR has potential for the pathological evaluation of stable CAD, cardiomyopathy, and risk stratification in CAD.
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Hernandez-Andrade E, Huntley ES, Bartal MF, Soto E, Johnson A. Fetal coronary circulation: the middle cardiac vein. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 61:269-270. [PMID: 36056766 DOI: 10.1002/uog.26060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/05/2022] [Accepted: 08/24/2022] [Indexed: 05/27/2023]
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Sonsoz MR, Inan D. Unroofed coronary sinus: A case vignette emphasizing the role of three-dimensional transesophageal echocardiogram. Kardiol Pol 2023; 81:1296-1297. [PMID: 38189512 DOI: 10.33963/v.kp.98404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024]
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Gibson CM, Ajmi I, von Koenig CL, Turco MA, Stone GW. Pressure-Controlled Intermittent Coronary Sinus Occlusion: A Novel Approach to Improve Microvascular Flow and Reduce Infarct Size in STEMI. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2022; 45:9-14. [PMID: 35918254 DOI: 10.1016/j.carrev.2022.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/21/2022] [Accepted: 07/19/2022] [Indexed: 01/04/2023]
Abstract
Despite successful primary percutaneous coronary intervention (PCI) for treatment of ST-segment elevation myocardial infarction (STEMI), myocardial salvage is frequently suboptimal resulting in large infarctions with increased rates of heart failure and death. Microvascular dysfunction after the procedure is frequently present and contributes directly to poor outcomes in STEMI. Pressure-controlled intermittent Coronary Sinus Occlusion (PiCSO) is a novel technology designed to mitigate microvascular dysfunction in STEMI. Non-randomized studies have suggested that PiCSO use during primary PCI in STEMI is safe, improves microvascular perfusion and reduces infarct size. Randomized trials are ongoing to investigate the safety and effectiveness of PiCSO in high-risk patients with anterior STEMI undergoing primary PCI.
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Ghijselings I. Question: An unusual flow from the coronary sinus. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2022; 11:e1. [PMID: 36174207 DOI: 10.1093/ehjacc/zuac055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Goel A, Gourav KP, Reddy S, Dasari G. Mal-positioned coronary sinus catheter masquerading as right atrium mass - Thanks to transesophageal echocardiography! JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:903-904. [PMID: 35544451 DOI: 10.1002/jcu.23223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
Mid esophageal 4 chamber view showing the mass in RA (red arrow) immediately after insertion of coronary sinus catheter. LA, Left atrium; LV, Left Ventricle; RA, Right atrium; RV, Right ventricle.
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Katekaru-Tokeshi DI, Menacho K, Jiménez-Santos M. Absence of the coronary sinus and hypertrophic cardiomyopathy. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:604. [PMID: 35151599 DOI: 10.1016/j.rec.2021.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
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Kaplan B, Evans WN, Restrepo H, Rothman A. Atresia of the Midportion of the Coronary Sinus: A Case Report. World J Pediatr Congenit Heart Surg 2022; 13:802-804. [PMID: 35585704 DOI: 10.1177/21501351221099940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 12-year-old with a history of critical pulmonary stenosis and moderate right ventricular hypoplasia underwent neonatal pulmonary valve dilation, an aortopulmonary shunt, and an infant cavopulmonary anastomosis with aortopulmonary shunt takedown. During a diagnostic cardiac catheterization at 12 years of age, angiography showed interruption in the midportion of the coronary sinus, which required no intervention.
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Severo A, Jiménez-Valero S, Galeote G, Moreno R, Jurado-Román A. Coronary Sinus Reducer Transfemoral Extraction After Intraprocedural Device Migration to the Pulmonary Artery. THE JOURNAL OF INVASIVE CARDIOLOGY 2022; 34:E345. [PMID: 35366230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Coronary sinus reducer migration during implantation is an unusual complication with no standard bailout strategy and to the best of our knowledge there is no description of migration to the pulmonary artery. A mother-and-child technique during implantation could be the safest way to avoid this complication.
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Halline C, Winegarner A, Maslow A, Gorgone M. Left Atrial Dissection Secondary to Retrograde Coronary Sinus Cannulation During a Stanford Acute Type-A Aortic Dissection Repair: A Case Report. A A Pract 2022; 16:e01568. [PMID: 35171844 PMCID: PMC8876416 DOI: 10.1213/xaa.0000000000001568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/21/2022]
Abstract
Left atrial (LA) dissections are rare phenomena, often iatrogenic, caused by blood flow into a false lumen, potentially obstructing the pulmonary veins or flow into the left ventricle. Severity can range from an incidental observation or complete circulatory collapse. While LA dissections are often associated with mitral valve repair, there are 2 reported cases of LA dissections associated with retrograde cardioplegia cannula insertion through the coronary sinus. Here, we present a large LA dissection that was directly visualized and tracked to a coronary sinus injury from the retrograde cardioplegia cannula. The clinical presentation and echocardiography findings informed our subsequent management.
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Bianchi G, Concistrè G, Haxhiademi D, Caliani B, Guarino M, Solinas M. Endoscopic Mitral Valve Repair in a Patient With Persistent Left Superior Vena Cava Draining Into the Coronary Sinus - Cannulation Technique and Surgical Management. Heart Lung Circ 2021; 31:e41-e44. [PMID: 34887182 DOI: 10.1016/j.hlc.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 11/14/2021] [Indexed: 11/18/2022]
Abstract
Persistence of the left superior vena cava is often an incidental finding during cardiac surgical procedures. In minimally invasive valvular surgery, it may jeopardise venous drainage and myocardial protection. This How-To-Do-It paper describes the cannulation strategy in a case of minimally invasive mitral surgery in a patient with persistence of the left superior vena cava and absence of the anonymous vein detected with preoperative multimodality imaging.
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