Creation of a coronary sinus to atrial communication in coronary sinus ostial atresia improves cardiac function after Fontan.

摘要

Coronary sinus ostial atresia is a rare anatomic condition which is occasionally associated with drainage of coronary veins via a persistent left-sided superior vena cava. This anatomic condition is normally clinically insignificant. However, when the systemic venous pressure is higher than that of the atrium, cardiac function can be impaired. We report our experience with a young adult who underwent a Fontan due to tricuspid atresia. The patient presented to our institution with poor systolic and diastolic ventricular function. A catheterization revealed an atretic coronary sinus ostium, and the coronary veins drained via a persistent left-sided superior vena cava. Creation of a communication from coronary sinus to the common atrium resulted in a significant decrease in coronary venous pressures. The patient has experienced improvement following the interventiona catheterization. (c) 2007 Wiley-Liss, Inc.