CT angiography for diagnosis and subcategorization of unroofed coronary sinus syndrome

Zhi, Aihua; Dai, Rongping; Ma, Wei-Guo; Zhang, Pei; Lv, Bin; Jiang, Shiliang

doi:10.21037/jtd.2017.09.03

Cited by 14 publications

(9 citation statements)

References 26 publications

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“…20,21 The cardiac CT scan and cardiac magnetic resonance imaging are suitable to identify CS anomalies. 9,22,23 However, the gold standard for measuring the diameter of CS is cardiac catheterization and aortography, although there are many problems in using these methods, such as invasiveness and ethical issues. Kronzon et al showed that transesophageal echocardiography is better than transthoracic echocardiography for measurement of CS.…”

Section: Resultsmentioning

confidence: 99%

Age-adjusted Reference Values and Z-scores of the Coronary Sinus Diameter among Healthy Children and Adolescents in Southern Iran

et al. 2021

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Background: Coronary sinus dimension is an important factor for diagnosing some types of cyanosis as well as congenital heart diseases and insertion of some devices into the coronary sinus if required. This study was designed to access the diameter and Z-score of the coronary sinus among children under 18 years of age. Methods: In this cross-sectional study on 95 individuals, the coronary sinus diameter was measured by transthoracic echocardiography in the four-chamber view at the connection to the right atrium, middle part, and distal end. The linear regression equation was utilized to determine age-adjust reference values, Z-scores, and the relationship between the individuals’ coronary sinus diameter age, height, and body surface area. The study was conducted from March to July 2020 in Namazi hospital clinic of Shiraz University of Medical Sciences, Shiraz, Iran. Results: The mean age of the persons who entered this study was 5.87±4.25 years. The mean coronary sinus diameter was 4.91±1.29 mm at the site of connection to the right atrium, 4.50±1.44 mm at the middle part, and 3.74±1.32 mm at the distal end. Coronary sinus diameter correlates positively with the participants’ age, weight, height, and body surface area (P<0.001). Conclusion: Coronary sinus diameter significantly correlates with the age, height, and body surface area of the cases. These features are useful in diagnosing some congenital heart diseases and insertion of suitable devices through it.

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Section: Resultsmentioning

confidence: 99%

Age-adjusted Reference Values and Z-scores of the Coronary Sinus Diameter among Healthy Children and Adolescents in Southern Iran

et al. 2021

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“…Type (A): A PLSVC connected to the CS. Type (B): Venous drainage through the UCS (Type IVb 27 ) to the LA. Type (C): Anomalous CS drainage (asterisk) into the RA through an accessory vein, such as an SV or a Thebesian vein.…”

Section: Resultsmentioning

confidence: 99%

Supraventricular tachycardia in patients with coronary sinus stenosis/atresia: Prevalence, anatomical features, and ablation outcomes

Weng¹,

Tang²,

Zhou³

et al. 2020

Cardiovasc electrophysiol

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Background: Supraventricular tachycardia (SVT) with coronary sinus (CS) ostial atresia (CSA) or coronary sinus stenosis (CSS) causes difficulty in electrophysiological procedures, but its characteristics are poorly understood. Objective: Study the anatomical and clinical features of SVT patients with CSA/CSS. Methods: Of 6128 patients with SVT undergoing electrophysiological procedures, consecutive patients with CSA/CSS were enrolled, and the baseline characteristics, imaging materials, intraoperative data, and follow-up outcomes were analyzed. Results: Thirteen patients, seven with CSA and six with CSS, underwent the electrophysiological procedure. Decapolar catheters were placed into the proximal CS in three cases, while the rest were placed at the free wall of the right atrium. Fourteen arrhythmias were confirmed: four atrioventricular nodal reentrant tachycardias, five left-sided accessory pathways, three paroxysmal atrial fibrillations, and two atrial flutters (AFLs). In addition to three patients who underwent only an electrophysiological study, the acute ablation success rate was 100% in 10 cases, with no procedure-related complications. After a median follow-up period of 59.6 months, only one case of atypical AFL recurred. For those cases (seven CSA and two CSS) with a total of 10 anomalous types of CS drainage, three types were classified: from the CS to the persistent left superior vena cava (n = 3), from an unroofed CS (n = 3), and from the CS to the small cardiac vein (n = 3) or Thebesian vein (n = 1). Conclusion: Patients with CSA/CSS may develop different kinds of SVT. Electrophysiological procedures for such patients are feasible and effective. An individualized mapping strategy based on the three types of CS drainage will be helpful.

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“…This is known as left-to-right shunting. This shunting can result in pulmonary edema [22]. There is a rise in cardiac output as a compensatory mechanism due to this unwanted blood loss from the aorta during the diastole.…”

Section: Discussionmentioning

confidence: 99%

A Rare Association of Patent Ductus Arteriosus (PDA) With Persistent Left Superior Vena Cava (PLSVC) and Unroofed Coronary Sinus (UCS) Terminating Into Left Atrium (LA): A Case Report of an Indian Infant

Sahai¹,

Ghosh²,

Agrawal³

et al. 2022

Cureus

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Unroofed coronary sinus syndrome (UCSS), also named coronary sinus (CS) septal defect, is a rare type of atrial septal defect (ASD) with the incidence less than 1% of the total number of ASDs. It is caused by incomplete formation of left atrial venous folds during embryonic development. There is communication between the CS and left atrium (LA) due to the presence of a left superior vena cava (LSVC) along with an incomplete or complete loss of the CS roof draining into the LA. It usually presents as mild breathlessness on exertion and the appearance of murmurs on auscultation. A case that is diagnosed as an unroofed CS (UCS) related to a continuous LSVC terminating into the CS, which further terminates into LA, along with a large patent ductus arteriosus (PDA) is a rare presentation.

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CT angiography for diagnosis and subcategorization of unroofed coronary sinus syndrome

Abstract: CTA and imaging reconstruction can provide excellent anatomical delineation of the heart, great vessels, and CS, and allows for precise diagnosis of URCS. This CTA classification scheme of URCS is simple and easy to use, and has important clinical implications for diagnosis and treatment.

Cited by 14 publications

References 26 publications

Age-adjusted Reference Values and Z-scores of the Coronary Sinus Diameter among Healthy Children and Adolescents in Southern Iran

Age-adjusted Reference Values and Z-scores of the Coronary Sinus Diameter among Healthy Children and Adolescents in Southern Iran

Supraventricular tachycardia in patients with coronary sinus stenosis/atresia: Prevalence, anatomical features, and ablation outcomes

A Rare Association of Patent Ductus Arteriosus (PDA) With Persistent Left Superior Vena Cava (PLSVC) and Unroofed Coronary Sinus (UCS) Terminating Into Left Atrium (LA): A Case Report of an Indian Infant

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