Partially unroofed coronary sinus with intact atrial septum in an elderly patient

Area of Science:

• Cardiology
• Cardiac Surgery
• Congenital Heart Disease

Background:

• Coronary sinus anomalies are rare congenital heart conditions.
• Partially unroofed coronary sinus (PUCS) is an uncommon variant, often associated with persistent left superior vena cava.
• Diagnosis during adult cardiac surgery is infrequent.

Observation:

• A 74-year-old female with hypertension and severe myxomatous bileaflet mitral valve prolapse presented with severe eccentric mitral regurgitation.
• The patient underwent cardiac surgery for mitral valve repair/replacement.
• Intraoperative findings revealed a partially unroofed coronary sinus without a persistent left superior vena cava.

Findings:

• The presence of a partially unroofed coronary sinus in the absence of a persistent left superior vena cava is exceptionally rare.
• This anatomical variation was incidentally discovered during surgical intervention for significant mitral valve pathology.

Implications:

• Highlights the importance of intraoperative awareness for rare cardiac anomalies.
• May influence surgical planning and technique in complex cardiac procedures.
• Contributes to the understanding of coronary sinus developmental variations.