Coronary sinus ostial stenosis with unroofed coronary sinus

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  • AIGA Mamoru
    Department of Cardiovascular Medicine, Tokyo Medical University Hachioji Medical Center
  • OOSHIMA Kazutaka
    Department of Cardiovascular Medicine, Tokyo Medical University Hachioji Medical Center
  • YAMADA Satoshi
    Department of Cardiovascular Medicine, Tokyo Medical University Hachioji Medical Center
  • TANAKA Nobuhiro
    Department of Cardiovascular Medicine, Tokyo Medical University Hachioji Medical Center

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  • 冠静脈洞開口部狭窄を合併したunroofed coronary sinusの1例

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<p>An 82-year-old male with paroxysmal atrial fibrillation was referred to our hospital for catheter ablation therapy. Transthoracic echocardiography (TTE) showed a dilated coronary sinus (CS), and there appeared to be a communication between the CS and the left atrium (LA) in the two-chamber view, suggestive of unroofed coronary sinus (UCS), but right-sided chambers were not dilated. Transesophageal echocardiography (TEE) was performed for a detailed investigation. Intravenous agitated saline contrast echocardiography through the left upper arm could not identify a persistent left superior vena cava. Three-dimensional transesophageal echocardiography (3D-TEE) revealed a direct communication between the terminal portion of the CS and LA through the deficit hole with a diameter of 15 mm. Moreover, the CS ostium was covered with a fenestrated membranous structure and stenosed. We diagnosed UCS with CS ostial stenosis. The CS ostial stenosis likely restricted the left-to-right shunt flow, preventing remarkable right heart volume overload. 3D-TEE was useful for evaluation of the structure of UCS and CS ostial stenosis.</p>

Journal

  • Choonpa Igaku

    Choonpa Igaku 46 (5), 437-441, 2019

    The Japan Society of Ultrasonics in Medicine

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