Abstract

A 64-year-old woman with heart palpitations was referred to our hospital. Electrocardiography revealed atrial fibrillation, and catheter ablation had been performed. Chest radiography showed enlargement of the superior vena cava and right atrium (RA; Panel A). Preoperative cardiac computed tomography (CT) showed a dilated RA while the coronary sinus (CS) was being drained into the left atrium (LA), instead of the RA, which indicated CS atresia with an unroofed CS (Panel B). And the CT demonstrated that the developed collateral coronary veins drained into the high RA and left brachiocephalic vein (Panels C and D, see Supplementary data online, Video S1). Left coronary angiography also revealed CS atresia, due to which the CS drained into the bottom of the LA and the high RA via collateral vessels (see Supplementary data online, Video S2). The catheter ablation for pulmonary vein isolation was performed successfully without CS cannulation. Open in new tabDownload slide Although cases of CS atresia accompanied by unroofed CS are rare, some patients experience supraventricular tachycardia. Preoperative cardiac CT evaluation is beneficial to patients as well as operators performing catheter ablation as treatment for supraventricular tachycardia. Supplementary material Supplementary material is available at European Heart Journal – Case Reports online. Consent: The authors confirm that written, informed consent was obtained from the patient, in line with COPE guidelines, for the submission and publication of this report. Funding: None declared. Data availability: No new data were generated or analysed in support of this research. Author notes Conflict of interest: None declared. © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com