scholarly journals Wide unroofed coronary sinus and cryptogenic stroke: a case report

2020 ◽  
Author(s):  
Savalan Babapoor-Farrokhran ◽  
Aditi Kalla ◽  
Behnam Bozorgnia ◽  
Aman Amanullah
Keyword(s):  
Coronary Sinus ◽  
Transthoracic Echocardiography ◽  
Cardiac Ct ◽  
Imaging Modality ◽  
Pulmonary Veins ◽  
Cryptogenic Stroke ◽  
Cardiac Anomaly ◽  
Heart Catheterization ◽  
Congenital Cardiac Anomaly ◽  
Unroofed Coronary Sinus

Abstract Background  Unroofed coronary sinus (UCS) is a rare congenital cardiac anomaly in which there is complete or partial absence of the roof of the coronary sinus (CS) resulting in a communication between the right and left atria. There are four types of UCS described in the literature. While usually asymptomatic and discovered incidentally on imaging, UCS can be the source of a brain abscess or paradoxical embolism. Case summary  A 62-year-old gentleman presented to the emergency department with sudden onset of right-sided weakness and subsequent unresponsiveness. His brain computed tomography (CT) was consistent with left-sided stroke. Transthoracic echocardiography was remarkable for a dilated CS and an agitated saline study was suggestive of an UCS. A gated cardiac CT with coronary angiography confirmed a wide communication between the CS and left atrium. Right heart catheterization did not show evidence of left to right shunt. He had no abnormal rhythm on telemetry monitoring throughout his hospital stay. Discussion  Unroofed coronary sinus is the least prevalent form of an atrial septal defect. Unroofed coronary sinus is usually asymptomatic and is diagnosed incidentally in imaging studies, however, it should be suspected in patients with cerebral emboli or evidence of left to right shunt with unexplained arterial desaturation. Transthoracic echocardiography is the most widely used imaging modality for the diagnosis of UCS but is limited in its ability to visualize the posterior cardiac structures such as the CS and pulmonary veins. Gated cardiac CT is a great diagnostic tool for UCS.

scholarly journals Isolated Cor Triatriatum Sinister: A Case Report

2020 ◽  
Vol 18 (1) ◽  
pp. 28-30
Author(s):  
Zanda Grīnberga ◽  
Pauls Sīlis ◽  
Elīna Ligere ◽  
Ingūna Lubaua ◽  
Inta Bergmane ◽  
...  
Keyword(s):  
Left Atrium ◽  
Pulmonary Veins ◽  
Surgical Excision ◽  
Venous Drainage ◽  
Treatment Method ◽  
Cor Triatriatum ◽  
Cardiac Anomaly ◽  
Congenital Cardiac Anomaly ◽  
Cor Triatriatum Sinister ◽  
The Right

SummaryCor triatriatum sinister is a rare congenital cardiac anomaly that has been identified in 0.1% of children with congenital heart disease. It is defined as a fibromuscular membrane that divides the left atrium into two chambers: a superior (proximal) that in most cases receives drainage from the pulmonary veins and an inferior (distal) chamber that communicates with the mitral valve and the left atrium. Cor triatriatum sinister can be an isolated lesion (approximately 25% of cases), but in many cases it is associated with other congenital cardiovascular anomalies, the most common one being – atrial septal defect(3). Symptoms in patients with cor triatriatum sinister are related to obstruction of pulmonary venous drainage, pressure loading of the right side of the heart and congestive cardiac failure. Depending on the severity of the obstruction and presence of associated cardiac anomalies it can be diagnosed at any age. Diagnosis is usually achieved by echocardiography in early infancy. Elective treatment method is surgical excision of the membrane. Here we present a pediatric patient (4 months old) presenting in cardiogenic shock with a successful correction of isolated cor triatriatum sinister. To confirm diagnosis and success of surgical repair, transthoracic and transesophageal echocardiography were used.

scholarly journals A case report of an elderly male with isolated coronary sinus atrial septal defect

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Junko Okamoto ◽  
Shinji Fukuhara ◽  
Hideki Ozawa ◽  
Takahiro Katsumata
Keyword(s):  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Coronary Sinus ◽  
Septal Defect ◽  
Superior Vena ◽  
Vena Cava ◽  
Cardiac Anomaly ◽  
Elderly Male ◽  
Direct Closure ◽  
Congenital Cardiac Anomaly

Abstract Background Isolated coronary sinus atrial septal defect (CSASD) is a rare congenital cardiac anomaly, comprising <1% of atrial septal defects. Elderly patients with this anomaly are even more uncommon and sometimes overlooked. Case summary A 73-year-old man with a history of electrical defibrillation therapy for atrial flutter presented with worsening exertional dyspnoea. Cardiac examination revealed CSASD without persistent left superior vena cava, showing only moderate tricuspid regurgitation. Surgical repair of the defect and regurgitant valve improved symptoms dramatically. Discussion Elderly patients with atrial arrhythmias might show uncommon presentations of congenital heart disease. Cardiologists should pay attention to enlarged right ventricle, pulmonary artery, and, in particular, enlarged coronary sinus. Direct closure with interrupted sutures secured with pledgets is effective in some case of terminal type of CSASD.

scholarly journals Anomalous drainage of left superior venacava into left atrium

2019 ◽  
Vol 6 (9) ◽  
pp. 3368
Author(s):  
Chandana Nirmala Chandrashekar ◽  
Padebettu Subramanya Seetharama Bhat ◽  
Manjunath Cholenahally Nanjappa
Keyword(s):  
Pulmonary Artery ◽  
Left Atrium ◽  
Coronary Sinus ◽  
Unusual Case ◽  
Pulmonary Veins ◽  
Proximal Part ◽  
Left Pulmonary Artery ◽  
Innominate Vein ◽  
Unroofed Coronary Sinus ◽  
Hemodynamic Alteration

The anomalies of drainage of systemic venous communications to the heart are many. But only few cause significant hemodynamic alteration and thus, complications. When they do, they need to be surgically corrected. We report an unusual case of a patient who was found to have left pulmonary veins draining into the left superior venacava (LSVC), which in turn was opening into the roof of the left atrium that had unroofed coronary sinus morphology. Innominate vein was absent. LSVC was divided cranial to where the pulmonary veins were draining into it. Lower end was suture closed. Proximal part of the LSVC was anastamosed to left pulmonary artery.

scholarly journals Multislice Computed Tomography Imaging of Total Anomalous Pulmonary Venous Circulation: Three Rare Case Reports

2018 ◽  
Vol 6 (1-2) ◽  
pp. 73-77
Author(s):  
Nusrat Ghafoor ◽  
Md Rokonujjaman Selim ◽  
Nawshin Siraj
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Left Atrium ◽  
Case Reports ◽  
Pulmonary Veins ◽  
Cardiac Anomaly ◽  
Congenital Cardiac Anomaly ◽  
Venous Circulation ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection

Total anomalous pulmonary venous connection is a rare congenital cardiac anomaly in which the pulmonary veins have no connection with the left atrium and connect directly to the right atrium or to one of the systemic veins. In the diagnosis of total anomalous pulmonary venous connection, the presence and severity of the venous obstruction is important. Computed Tomography (CT) imaging is known to be a useful method for the evaluation of total anomalous pulmonary venous connection. Here we report 3 cases of total anomalous pulmonary venous circulation (TAPVC) where 32 slice CT scan played an important role in pre-operative diagnosis and management. Age of the patients ranged from seven months to sixteen years. Symptoms of the patients’ varied from fatigue, shortness of breath, mild cyanosis and reduced growth for their age. Echocardiography done revealed dilated right cardiac chambers and atrial septal defect (ASD) with suspicion of TAPVC. CT scan was performed and it provided detailed information about intra-cardiac anatomy, pulmonary veins and their confluence, route, drainage and most importantly their distance and relation with the left atrium. It also provided information about coronary sinus and its drainage. This information is very important for surgical mapping and planning. Ibrahim Card Med J 2016; 6 (1&2): 73-77

scholarly journals P1739 Diameter of the pulmonary artery in relation to the ascending aorta: a promising parameter for the diagnosis of pulmonary hypertension

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Schneider ◽  
H Ran ◽  
A M Pistritto ◽  
C Gerges ◽  
H Heidari ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Transthoracic Echocardiography ◽  
Imaging Modality ◽  
Area Under The Curve ◽  
Diagnostic Algorithm ◽  
Right Heart Catheterization ◽  
Ascending Aorta ◽  
Heart Catheterization ◽  
Technological Advances

Abstract Background Pulmonary hypertension (PH) is a disease with significant morbidity and mortality. The first imaging modality in the diagnostic algorithm is transthoracic echocardiography (TTE). Despite significant technological advances in recent years, there are still patients with PH who are missed by TTE. The pulmonary artery to ascending aorta ratio (PA/Ao-R) has been evaluated in cardiac magnetic resonance (CMR) and computed tomography (CT) studies. The ratio was able to detect patients with PH, it correlated with hemodynamics, and it was predictive for mortality. We sought to evaluate the diagnostic accuracy of PA/Ao-R measured by TTE in the detection of PH. Methods We evaluated consecutive patients who received quasi-simultaneous transthoracic echocardiography and right heart catheterization (RHC) for evaluation of pulmonary hypertension between July 2015 and July 2016. Results A total of 84 patients fulfilled the inclusion criteria, 47 were female, mean age was 65 years. Median PA/Ao-R was 0.8 (Q1;Q3 0.69;0.94). Seventy patients had PH (median mean pulmonary artery pressure (mPAP) was 35.5 mmHg, Q1;Q3 27;47). The area under the curve for the diagnosis of PH via PA/Ao-R was 0.853. A cut-off of 1 was chosen for further analysis. Sensitivity for the diagnosis of PH was 100%, specificity was 23%. PA/Ao-R correlated with mPAP (r = 0.65, p < 0.001), and pulmonary vascular resistance (r = 0.68, p < 0.001). In the subgroup of patients with PH, those patients with a PA/Ao-R of ≥1 had significantly (p < 0.001) higher pulmonary pressures than those below, with a mean mPAP of 53 mmHg as compared to 38.5 mmHg. Conclusion PA/Ao-R correlates with mPAP. A ratio of ≥1 should prompt suspicion for the presence of PH. PA/Ao-R should be reported in every patient who is evaluated for PH.

scholarly journals Late-onset total anomalous pulmonary venous connection in a 70-year-old woman

2021 ◽  
Vol 14 (9) ◽  
pp. e245186
Author(s):  
Sho Takagi ◽  
Akio Nakasu ◽  
Junji Yanagisawa ◽  
Yoshihiro Goto
Keyword(s):  
Surgical Treatment ◽  
Septal Defect ◽  
Clinical Presentation ◽  
Pulmonary Valve ◽  
Late Onset ◽  
Pulmonary Veins ◽  
Cardiac Anomaly ◽  
Residual Shunt ◽  
Congenital Cardiac Anomaly ◽  
Anomalous Pulmonary Venous Connection

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital cardiac anomaly. There are a few reports of untreated TAPVC diagnosed in patients older than 60 years. Herein, we report the successful surgical treatment of TAPVC in a 70-year-old woman. A 70-year-old woman with TAPVC presented with symptoms of acute heart failure. We closed an atrial septal defect and performed tricuspid annuloplasty and commissurotomy of the pulmonary valve. Postoperative CT showed no residual shunt, and the pulmonary veins drained into the left atrium. She had an uneventful postoperative course. This report describes the case of the oldest known patient who underwent surgical treatment for TAPVC. Surviving into adulthood with little or no symptoms is uncommon in patients with TAPVC, and cases of late-onset TAPVC, such as our case, are rare. Nevertheless, close vigilance is necessary to prevent misdiagnosis in patients with this clinical presentation.

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