Percutaneous Closure of Coronary Sinus Atrial Septal Defect across Two Spectrums: A Case Series

Coronary Sinus ASD or Unroofed Coronary Sinus defect is the rarest form of atrial septal defect and is seldom reported due to its non specific manifestations and difficult diagnosis on transthoracic echocardiography. Multimodality imaging is required for accurate diagnosis of this defect. The standard treatment is surgical and it has been incidentally diagnosed during other cardiac surgeries. Here we present two such patients who presented to us with non-specific complaints and were incidentally detected to have RA, RV dilatation. On detailed transthoracic and transoesophageal echocardiography, they were found to have a coronary sinus ASD; one with a persistent left vena cava (PLSVC) and another without a PLSVC. They were both closed using atrial septal occluder defect percutaneously. Transcutaneous closure of this defect is possible after meticulous planning and proper understanding of the anatomy. It is safe and can be performed if this defect is diagnosed correctly.