title: Surgical approach to left ventricular inflow obstruction due to dilated coronary sinus.
abstract: BACKGROUND
  Left superior vena cava draining to a dilated coronary sinus can cause left ventricular inflow obstruction. Our purpose is to report 4 severely ill patients with this malformation who were operated upon and in whom repair was accomplished using an original surgical approach.
  
  
  METHODS
  An operative procedure was designed, which included complete resection of the wall of the coronary sinus along its entire extension in the left atrium; division of the left superior vena cava; and establishment of the left superior vena cava-right atrial continuity by a wide left superior vena cava-right atrial appendage anastomosis. The series included 1 patient with interrupted inferior vena cava-hemiazygous continuation to left superior vena cava.
  
  
  RESULTS
  There were no deaths. Absence of residual left ventricular inflow obstruction was demonstrated at follow-up in all cases, together with an unobstructed left superior vena cava-right atrial appendage-right atrial connection.
  
  
  CONCLUSIONS
  A predictable relief of the left ventricular inflow obstruction, together with preservation of an adequate drainage for the systemic venous return, were both achieved with this repair.
authors.affiliation: Division of Cardiovascular Surgery, Hospital de Niños Pedro Elizalde, Buenos Aires, Argentina. florentino_jose@yahoo.com
authors.forename: Florentino J
authors.initials: FJ
authors.lastname: Vargas
authors.forename: Jorge
authors.initials: J
authors.lastname: Rozenbaum
authors.forename: Ricardo
authors.initials: R
authors.lastname: Lopez
authors.forename: Miguel
authors.initials: M
authors.lastname: Granja
authors.forename: Ana
authors.initials: A
authors.lastname: De Dios
authors.forename: Beatriz
authors.initials: B
authors.lastname: Zarlenga
authors.forename: Enrique
authors.initials: E
authors.lastname: Flores
authors.forename: Enrique
authors.initials: E
authors.lastname: Fischman
authors.forename: Eduardo
authors.initials: E
authors.lastname: Kreutzer
mesh_terms: D020517:Atrial Appendage / Q000601:surgery; D016121:Brachiocephalic Veins / Q000002:abnormalities; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003326:Coronary Circulation; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000601:surgery*; D004108:Dilatation, Pathologic / Q000601:surgery; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000002:abnormalities*; D014694:Ventricular Outflow Obstruction / Q000209:etiology / Q000601:surgery*