Atresia of the orifice of the coronary sinus after surgery

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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

Shigeru Tateno1, Koichiro Niwa, Masaru Terai

  • 1Department of Pediatrics, Chiba Cardiovascular Center, 575, Tsurumai, Ichirara, Chiba, Japan 290-0512. tatenoji@sa2.so-net.ne.jp

Cardiology in the Young
|October 9, 2002
PubMed

Insights

This case report details a patient with multiple congenital heart anomalies, including a coronary arteriovenous fistula and persistent left superior caval vein. ST segment depression was noted on exercise electrocardiography post-surgical repair.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • Coronary arteriovenous fistulas are rare congenital heart defects.
  • Atresia of the coronary sinus orifice and persistence of the left superior caval vein are uncommon anomalies.
  • Surgical reconstruction of the coronary sinus is a complex procedure.

Observation:

  • The patient presented with a complex cardiac anomaly involving a coronary arteriovenous fistula.
  • The patient also had atresia of the coronary sinus orifice and a persistent left superior caval vein.
  • Initial surgical reconstruction of the coronary sinus was performed.

Findings:

  • Exercise electrocardiography revealed ST segment depression.
  • This finding was noted long after the initial surgical intervention.
  • The ST segment depression suggests potential residual or new ischemic changes.

Implications:

  • This case highlights the importance of long-term follow-up in patients with complex congenital heart defects.
  • Understanding the long-term implications of surgical repair for coronary sinus anomalies is crucial.
  • Further investigation may be needed to elucidate the cause of late-onset ST segment depression.

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