Imaging of the Coronary Sinus: Normal Anatomy and Congenital Abnormalities

Shah, Sanket; Teague, Shawn D.; Lu, Jimmy C.; Dorfman, Adam L.; Kazerooni, Ella A.; Agarwal, Prachi P.

doi:10.1148/rg.324105220

Cited by 80 publications

(79 citation statements)

References 53 publications

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“…Normally the right anterior cardinal vein and the right common cardinal vein merge to form the SVC while the left anterior cardinal vein and the left common cardinal vein must undergo atrophy. Patency of embryonic veins lead to multiple variations for example double SVC, double inferior vena cava (IVC) or other venous connections which don't normally exist [6]. The PLSVC represents failure of obliteration of the left anterior cardinal vein in early embryological development [7].…”

Section: Discussionmentioning

confidence: 99%

Left persistent superior vena cava with large coronary sinus: A case report

Doğan¹,

Doğan²,

Gül³

et al. 2018

Journal of Surgery and Medicine

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This is an open access article distributed under the terms of the CreativeCommons Attribution-Non Commercial-NoDerivatives License 4.0 (CC BY-NC-ND 4.0) where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. AbstractPersistent left superior vena cava (LPSVC) is a rare and important congenital venous anomaly. It is caused by a defect in the closure of the left anterior cardinal vein during cardiac development. The LPSVC drains into the right atrium via the coronary sinus (CS) in 90% of cases, connects to the left atrium in 10 % of them. When cardiac anomalies are present, LPSVC is usually linked directly to left atrium. Thus, LPSVC which drains in the CS is generally isolated and asymptomatic. In our case, patient presented a heavy respiratory symptomatology without any diagnosis since all of the respiratory tests were normal. After realization of a computed tomography (CT), LPSVC had been discovered inducing a huge dilatation of CS, which its diameter was three times more than reported in literature and without any associated congenital heart disease. LPSVC seems to be a complex anatomic variation with different clinic and anatomic shapes. CS dilatation can be found in association with LPSVC in CT. As a result, it is important to use non-invasive cardiovascular examinations to make an optimal diagnosis of congenital cardiovascular variations and in order to avoid further interventional complications. ÖzKalıcı sol superior vena kava (LPSVC) nadir ve önemli bir konjenital venöz anomalidir. Bu anomali, kardiyak gelişim sırasında sol anterior kardinal venin regresyonunda bir defektten kaynaklanır. LPSVC, % 90 oranında koroner sinüs (CS) yoluyla sağ atriyuma akar, % 10'unda sol atriyuma bağlanır. Kardiyak anomaliler mevcut olduğunda, LPSVC genellikle doğrudan sol atriyuma bağlanır. CS'ye drene olan LPSVC genellikle izole ve asemptomatiktir (4). Bizim olgumuzda, solunum testlerinin tümü normaldi ancak hasta herhangi bir tanı olmaksızın ağır bir solunum semptomatolojisi sundu. Bilgisayarlı tomografi (BT)'de LPSVC'nin, CS dilatasyonunu indülendiği saptanmıştır; CS literatürde belirtilen normal boyutun 3 kat üzerinde izlenmekteydi, herhangi bir konjenital anamali saptanmadı. LPSVC, farklı klinik ve anatomik şekillerle kompleks bir anatomik varyasyon gibi görünmektedir. CS dilatasyonu BT'de LPSVC ile ilişkili olarak bulunabilir. Sonuç olarak, konjenital kardiyovasküler varyasyonların optimal tanısını koymak ve girişimsel komplikasyonları önlemek için non-invaziv kardiyovasküler muayenelerin kullanılması önemlidir. Anahtar kelimeler: Superior vena cava, Sol persistan vena kava, Toraks radyolojisi

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Section: Discussionmentioning

confidence: 99%

Left persistent superior vena cava with large coronary sinus: A case report

Doğan¹,

Doğan²,

Gül³

et al. 2018

Journal of Surgery and Medicine

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“…This venous anomaly causes a right‐to‐left shunt, as desaturated systemic venous blood directly enters the left atrium. It is important to completely define the venous anatomy to avoid confusion with mirror image venous branching to a LSVC and an absent RSVC .…”

Section: Discussionmentioning

confidence: 99%

Transcatheter occlusion of a persistent left superior vena cava to the left atrium using the transseptal approach

Zampi

Sznycer-Taub

Grifka

2013

Cathet Cardio Intervent

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A persistent left superior vena cava (LSVC) is a common venous anomaly, occurring in up to 10% of patients with congenital heart defects. Usually, a LSVC drains into the coronary sinus, then to the right atrium. The LSVC can drain directly to the left atrium, resulting in a right-to-left shunt and systemic desaturation. Historically, surgery has been used to address this lesion. Transcatheter occlusion of the LSVC is an alternative to surgery. We report the novel use of the transseptal approach to access the LSVC, and device occlusion using the Amplatzer Vascular Plug-II.

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“…The CT technique is similar to that for routine coronary CT angiography. However, for optimal visualization of the coronary vein, an additional delay of 4 seconds compared to that used for coronary CT angiography is appropriate [34].…”

Section: Noninvasive Coronary Vein Mapping Prior To Placement Of Bivementioning

confidence: 99%

Non-Coronary Findings on Cardiac Computed Tomography in Adults: What Radiologists Should Know

Lee

Ahn

et al. 2017

Cardiovasc Imaging Asia

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INtroductIoNRecent advances in technology have made cardiac computed tomography (CT) a useful tool for detection of coronary artery disease. Several studies using 64-slice CT demonstrated high sensitivity (96-99%) and a negative predictive value (93-99%) of cardiac CT in excluding significant coronary artery disease [1][2][3]. Therefore, cardiac CT can act as a gatekeeper to invasive coronary angiography. In addition, the appropriateness criteria for cardiac CT published by the American College of Cardiology list various non-coronary applications [4]. These include evaluation of 1) complex congenital heart disease, 2) cardiac masses, 3) pericardial conditions, 4) pulmonary vein anatomy prior to invasive radiofrequency ablation (RFA) in atrial fibrillation, 5) noninvasive coronary vein mapping prior to placement of a biventricular pacemaker, 6) suspected aortic dissection or thoracic aortic aneurysm, and 7) suspected pulmonary embolism. In this article, we will review the non-coronary application of cardiac CT and demonstrate typical CT case findings in adults. Because non-electrocardiogram (ECG)-gated CT is usually sufficient to assess a thoracic aortic aneurysm or pulmonary embolism, we excluded these conditions in this pictorial essay. AssessmeNt of complex coNgeNItAl heArt dIseAseCardiac CT can simultaneously provide information about the great vessels, cardiac chambers, and valve anomalies, with excellent spatial resolution and fast acquisition time in adult congenital heart disease [5].Atrial septal defect (ASD) is the most common congenital heart disease. Among the four subtypes of ASD, ostium secundum ASD is the most common (70-80%), followed by ostium primum ASD (15%), sinus venosus ASD (10%), and coronary sinus ASD (<1%) [6]. Cardiac CT can help to evaluate ASD and its subtypes, measure a defect or rim size, and assess a combined anomaly. In most cases of ostium primum ASD, the anterior leaf of the mitral valve is cleft. Partial anomalous pulmonary venous return (PAPVR) is commonly associated with approximately 85% of sinus venosus and 10% to 15% of ostium secundum ASD cases (Fig. 1) [7].Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital heart disease with atrioventricular and ventriculoarterial discordance. Ventriculoarterial discordance indicates that the morphological right ventricle connects to the aorta, and the morphological left ventricle connects to the pulmonary artery (Fig. 2). This double discordance results in physiologically corrected circulation, with the morphological left ventricle supplying the pulmonary circulation, and the cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Cardiac computed tomography (CT) is useful for the assessment of both non-coronary cardiac disease and coronary artery disease...

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Imaging of the Coronary Sinus: Normal Anatomy and Congenital Abnormalities

Cited by 80 publications

References 53 publications

Left persistent superior vena cava with large coronary sinus: A case report

Left persistent superior vena cava with large coronary sinus: A case report

Transcatheter occlusion of a persistent left superior vena cava to the left atrium using the transseptal approach

Non-Coronary Findings on Cardiac Computed Tomography in Adults: What Radiologists Should Know

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