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Coronary Sinus Orifice Atresia Associated with Persistent Left Superior Vena Cava: A Case Report with Literature

Guang Song1, Weidong Ren1, Yixin Chen1

  • 1Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.

Echocardiography (Mount Kisco, N.Y.)
|February 10, 2016
PubMed

Insights

Coronary sinus orifice atresia, often with persistent left superior vena cava, presents diagnostic challenges. Diagnosis relies on identifying reversed flow in the persistent left superior vena cava.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Congenital Malformations

Background:

  • Coronary sinus (CS) orifice atresia is a rare congenital anomaly.
  • It is frequently associated with persistent left superior vena cava (PLSVC).
  • Preoperative diagnosis of this condition is notably difficult.

Observation:

  • The primary diagnostic clue is an abnormal, reversed direction of blood flow within the PLSVC.
  • A case of a 69-year-old woman with CS orifice atresia and PLSVC is presented.
  • A retrospective review of 99 cases, including the presented one, was conducted.

Findings:

  • The study identified that CS orifice atresia is commonly linked with an enlarged CS (>12 mm) and a small PLSVC (≤5 mm).
  • Literature review indicates an 81% incidence of enlarged CS and an 87% incidence of small PLSVC in associated cases.

Implications:

  • Understanding these associated morphologic features can aid in the preoperative diagnosis of CS orifice atresia.
  • Recognition of reversed flow in PLSVC is critical for identifying this rare malformation.
  • Further research into diagnostic modalities and management strategies for this condition is warranted.

Keywords:
coronary sinussuperior vena cava

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