Transesophageal echocardiographic diagnosis of coronary sinus orifice atresia

Echocardiographic diagnosis of coronary sinus ostial atresia

Coronary sinus ostial atresia is a rare anomaly that can result in serious hemodynamic sequelae if the decompressing vessel is occluded. Echocardiographic recognition of this malformation in patients with coexistent congenital heart disease before catheterization or surgical intervention may prevent occlusion of the decompressing left superior vena cava.

Anatomic and hemodynamic considerations influencing the efficiency of retrograde cardioplegia

One of the major issues raised by cardiac surgical procedures requiring cardiopulmonary bypass is the question of myocardial protection. The preferred route for the administration of cardioplegia is controversial. A number of studies show the beneficial effects of retrograde cardioplegia but some demonstrate only partial or poor myocardial protection. This paper reviews the anatomy and anatomic variations of the coronary sinus, the coronary sinus orifice and cardiac veins, and the major systemic venous drainage, all of which may affect the distribution of retrograde cardioplegia.

The surgical importance of coronary sinus orifice atresia

Coronary sinus orifice atresia is rare. We describe two cases, one with an atrioventricular septal defect and another with supracardiac totally anomalous pulmonary venous drainage. The association with the latter has not been described previously. The importance of diagnosing the defect is emphasized and surgical treatment is discussed.