Echocardiographic Diagnosis and Surgical Closure of Coronary Sinus Type of Atrial Septal Defect

Abstract

Coronary sinus type of atrial septal defect (ASD CS) is a rare cardiac anomaly and is rarely diagnosed by only transthoracic echocardiography prior to surgical operation. We now describe a technique to treat this defect with the aid of two-dimensional echocardiography, which prevents trauma to the conduction system and maintains drainage from the coronary sinus into the right atrium (RA).

A Rare Congenital Cardiac Defect: Isolated Coronary Sinus Septal Defect and the Challenges of Diagnosis in a Child

“…Coronary sinus septal defect is rare, and when it occurs in isolation, the diagnosis can sometimes be difficult. 2 Even though it may be diagnosed by transthoracic echocardiogram and/or TEE with color Doppler, cardiac catheterization, multidetector cardiac computed tomography, or cardiac MRI, 5 a higher index of suspicion is needed to pursue other imaging modalities after the initial transthoracic echocardiogram. The physiology of this defect is similar to that of secundum ASD with right heart dilation, and the other associated long-term complications and other consequences such as brain abscess or cerebral emboli may result from a right-to-left shunt.…”

“… 2 , 3 , 4 Coronary sinus septal defect is almost always associated with a PLSVC, and very few cases of isolated CSSD without left superior vena cava (SVC) have been reported in the literature. 5 Most of these cases are sometimes missed or difficult to diagnose and may be found incidentally in adulthood. 6 We report a case of CSSD in an asymptomatic 11-year-old whose diagnosis was initially challenging but was ultimately accomplished and who had a successful surgical repair.…”

Unroofed coronary sinus: An unusual interatrial communication and a rare childhood entity

“…[123] Such defects are often difficult to diagnose and may even be overlooked during surgery for complex congenital heart disease. [1234] In this defect, the coronary sinus forms initially within the left atrioventricular groove. Depending on the extent of dissolution of its wall adjacent to the left atrium, along with the corresponding left atrial wall, a communication between the atriums through the persisting mouth of the sinus is produced.…”

“…[123] An isolated coronary sinus to left atrial fenestration is extremely unusual. [1234] It often poses diagnostic difficulties. [234] We report a case of this unusual form of interatrial communication in a 7-year-old girl child who presented to us with breathlessness on exertion.…”