Inability to Cannulate the Coronary Sinus in Patients with Supraventricular Arrhythmias: Congenital and Acquired Coronary Sinus Atresia

Springer Science and Business Media LLC - Tập 12 - Trang 123-127 - 2005
Paul Khairy1,2, John K. Triedman1, Amy Juraszek3, Frank Cecchin1
1Electrophysiology Service, Department of Cardiology, Children’s Hospital Boston, Harvard Medical School, USA
2Canada Research Chair, Electrophysiology and Adult Congenital Heart Disease, Montreal Heart Institute, Quebec, Canada, HIT 1C8
3Department of Pathology, Children’s Hospital Boston, Harvard Medical School, USA

Tóm tắt

We report 4 cases of congenital and acquired coronary sinus ostial atresia incidentally found during electrophysiologic assessment for supraventricular arrhythmias. Congenital variants consisted of coronary sinus drainage predominantly via persistent left superior vena cavae and partial coronary sinus unroofing into the left atrium. The acquired variant was inadvertently produced during surgery for cor triatriatum. A variety of electrophysiologic substrates including right and left-sided accessory pathways and both typical and atypical AV nodal reciprocating tachycardia were identified. Approaches to imaging and accessing the coronary sinus when the os cannot be cannulated are discussed, including a search for right atrial accessory venous collaterals, venography to rule-out a persistent left superior vena cava, and coronary angiography.

Tài liệu tham khảo

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Springer Science and Business Media LLC

Tập 12

123-127

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