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Occlusion of the coronary sinus ostium: a danger for cavopulmonary anastomosis

Dana R Janssen1, Thomas P Graham, Thomas P Doyle

  • 1Division of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 25, 2004
PubMed

Insights

Coronary sinus ostial obstruction is a rare risk for single-ventricle palliation patients needing a Glenn anastomosis. Balloon occlusion angiography aids in diagnosing this condition before surgery.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Single-ventricle physiology often requires surgical palliation, such as the Glenn anastomosis.
  • Coronary sinus (CS) ostial obstruction is a rare but significant anomaly.
  • This obstruction can complicate surgical palliation by creating unique risks.

Observation:

  • Three cases of single-ventricle physiology with CS ostial obstruction were identified.
  • The obstruction was found to decompress via a persistent left superior vena cava.
  • Diagnosis was established during cardiac catheterization.

Findings:

  • Preoperative diagnosis of CS ostial obstruction is crucial.
  • Inadvertent ligation or coil occlusion are potential surgical risks.
  • Balloon occlusion angiography demonstrated utility in diagnosing CS ostial obstruction.

Implications:

  • Accurate preoperative diagnosis of CS ostial obstruction is vital for surgical planning.
  • This diagnosis helps prevent intraoperative complications during Glenn anastomosis.
  • Understanding this rare anomaly improves outcomes for complex congenital heart disease patients.

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