title: Intraoperative diagnosis of unroofed coronary sinus after aortic valve replacement.
abstract: A patient with combined aortic insufficiency and stenosis underwent aortic valve replacement. After weaning off cardiopulmonary bypass, a new shunt into the left atrium was noted that had not been apparent on multiple previous echocardiographs. Using an agitated saline test, we confirmed a shunt between the coronary sinus and left atrium. The assumption was made that there had been an iatrogenic fistula created with placement of the retrograde catheter; however, upon opening the left atrium it was realized that the patient had a previously undiagnosed, congenitally unroofed coronary sinus. It was repaired primarily and the patient had an uneventful recovery.
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Kingston General Hospital, Queens University, Kingston, Ontario, Canada. payned@kgh.kari.net
authors.forename: Darrin M
authors.initials: DM
authors.lastname: Payne
authors.forename: Andrew
authors.initials: A
authors.lastname: Hamilton
authors.forename: Brian
authors.initials: B
authors.lastname: Milne
authors.forename: Robert
authors.initials: R
authors.lastname: Tanzola
authors.forename: Michael
authors.initials: M
authors.lastname: O'Reilly
mesh_terms: D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D054326:Coronary Sinus / Q000002:abnormalities* / Q000000981:diagnostic imaging; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged