Surgical approach to left ventricular inflow obstruction due to dilated coronary sinus.
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.
Vargas
Florentino J
FJ
Division of Cardiovascular Surgery, Hospital de Niños Pedro Elizalde, Buenos Aires, Argentina. florentino_jose@yahoo.com
Rozenbaum
Jorge
J
Lopez
Ricardo
R
Granja
Miguel
M
De Dios
Ana
A
Zarlenga
Beatriz
B
Flores
Enrique
E
Fischman
Enrique
E
Kreutzer
Eduardo
E
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*