TY - JOUR
T1 - Inability to cannulate the coronary sinus in patients with supraventricular arrhythmias
T2 - Congenital and acquired coronary sinus atresia
AU - Khairy, Paul
AU - Triedman, John K.
AU - Juraszek, Amy
AU - Cecchin, Frank
N1 - Funding Information:
Supported in part by the Canada Research Chair in Electrophysiology and Adult Congenital Heart Disease (PK).
PY - 2005/3
Y1 - 2005/3
N2 - We report 4 cases of congenital and acquired coronary sinus ostial atresia incidentally found during electrophysiologic assessment for supraventricular arrhythmias. Congenital variants consisted of coronary sinus drainage predominantly via persistent left superior vena cavae and partial coronary sinus unroofing into the left atrium. The acquired variant was inadvertently produced during surgery for cor triatriatum. A variety of electrophysiologic substrates including right and left-sided accessory pathways and both typical and atypical AV nodal reciprocating tachycardia were identified. Approaches to imaging and accessing the coronary sinus when the os cannot be cannulated are discussed, including a search for right atrial accessory venous collaterals, venography to rule-out a persistent left superior vena cava, and coronary angiography.
AB - We report 4 cases of congenital and acquired coronary sinus ostial atresia incidentally found during electrophysiologic assessment for supraventricular arrhythmias. Congenital variants consisted of coronary sinus drainage predominantly via persistent left superior vena cavae and partial coronary sinus unroofing into the left atrium. The acquired variant was inadvertently produced during surgery for cor triatriatum. A variety of electrophysiologic substrates including right and left-sided accessory pathways and both typical and atypical AV nodal reciprocating tachycardia were identified. Approaches to imaging and accessing the coronary sinus when the os cannot be cannulated are discussed, including a search for right atrial accessory venous collaterals, venography to rule-out a persistent left superior vena cava, and coronary angiography.
KW - AV node reentrant tachycardia
KW - Accessory pathway
KW - Congenital heart disease
KW - Coronary sinus ostial atresia
KW - Electrophysiologic study
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U2 - 10.1007/s10840-005-6547-1
DO - 10.1007/s10840-005-6547-1
M3 - Article
C2 - 15744464
AN - SCOPUS:15244358918
SN - 1383-875X
VL - 12
SP - 123
EP - 127
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
IS - 2
ER -