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Updated: May 26, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Intraoperative diagnosis of unroofed coronary sinus after aortic valve replacement
Darrin M Payne1, Andrew Hamilton, Brian Milne
1Department of Surgery, Division of Cardiac Surgery, Kingston General Hospital, Queens University, Kingston, Ontario, Canada. payned@kgh.kari.net
Abstract:
A patient with combined aortic insufficiency and stenosis underwent aortic valve replacement. After weaning off cardiopulmonary bypass, a new shunt into the left atrium was noted that had not been apparent on multiple previous echocardiographs. Using an agitated saline test, we confirmed a shunt between the coronary sinus and left atrium. The assumption was made that there had been an iatrogenic fistula created with placement of the retrograde catheter; however, upon opening the left atrium it was realized that the patient had a previously undiagnosed, congenitally unroofed coronary sinus. It was repaired primarily and the patient had an uneventful recovery.
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