A Surgical Case of Partially Unroofed Coronary Sinus Atrial Septal Defect in an Elderly Patient Diagnosed by Preoperative Contrast-Enhanced Computed Tomography

Norihisa Yuge; Susumu Manabe; Daiki Hirayama; Ryuki Yamada; Mariko Hori; Tomohiro Saito; Nobuhiro Mochizuki; Koichiro Sugimura; Hiroaki Shimokawa

doi:10.1536/ihj.23-401

Case Reports

A Surgical Case of Partially Unroofed Coronary Sinus Atrial Septal Defect in an Elderly Patient Diagnosed by Preoperative Contrast-Enhanced Computed Tomography

Norihisa Yuge, Susumu Manabe, Daiki Hirayama, Ryuki Yamada, Mariko Hori, Tomohiro Saito, Nobuhiro Mochizuki, Koichiro Sugimura, Hiroaki Shimokawa

Author information

Norihisa Yuge
Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
Susumu Manabe
Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
Daiki Hirayama
Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
Ryuki Yamada
Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
Mariko Hori
Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
Tomohiro Saito
Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
Nobuhiro Mochizuki
Department of Cardiac Surgery, International University of Health and Welfare Narita Hospital
Koichiro Sugimura
Department of Cardiology, International University of Health and Welfare Narita Hospital
Hiroaki Shimokawa
Graduate School, International University of Health and Welfare

Keywords: Preoperative diagnosis, Appropriate surgical procedure

JOURNAL FREE ACCESS

2024 Volume 65 Issue 1 Pages 155-158

DOI https://doi.org/10.1536/ihj.23-401

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Abstract

Unroofed coronary sinus syndrome is a rare congenital cardiac anomaly, involving some anatomical variations. Approximately 60% of patients with unroofed coronary sinus syndrome have a concomitant atrial septal defect, which is termed unroofed coronary sinus atrial septal defect (CSASD). The precise detection of these abnormalities has been usually difficult with conventional echocardiography, mostly due to its small and complex structures. Herein, we report a case with unroofed coronary sinus atrial septal defect, in which preoperative contrast-enhanced computed tomography (CT) was useful in the operative decision making. We successfully repaired the defective roof of the coronary sinus with a bovine patch, while eliminating the inter-atrial shunt. The patient's postoperative course was uneventful with no residual shunt.

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