Abstract
We report a case of atrioventricular reentrant tachycardia (AVRT) with ostial atresia of the coronary sinus (CS). Without the anatomic angiography, radiofrequency (RF) energy was applied at the mitral valve annulus and the bypass tract was eliminated. After the therapy procedure, by CS angiography, we knew the persistent left superior vena cava (PLSVC), and the coronary sinus was connected with vena cava superior, very thin in a diameter. The therapy procedure was successful. The patient has remained completely symptom free.
Highlights
Coronary sinus (CS) atresia is a rare cardiac anatomic variant which causes failure to cannulate coronary sinus (CS) and considerable challenges in affecting cure
We report a case of CS ostial atresia with anomalous venous drainage into persistent left superior vena cavas (PLSVC) with a left-sided accessory pathway (AP) that was successfully eliminated by catheter ablation
A 12-lead ECG done during the palpitation revealed a regular, narrow QRS tachycardia at a rate of 170 bpm with P’-waves in leads II and aVF, QRS-P’ interval was 86ms; this suggested that the patient had an atrioventricular reentrant tachycardia (AVRT) through a concealed accessory pathway (AP)
Summary
Coronary sinus (CS) atresia is a rare cardiac anatomic variant which causes failure to cannulate CS and considerable challenges in affecting cure. CS ostial atresia was associated with a few persistent left superior vena cavas (PLSVC), an unroofed coronary sinus, or was a postoperative complication [1,2,3,4,5]. Patients with CS ostial atresia have been reported to have atrioventricular reentrant tachycardia [3,4,5], atrial flutter [4], and atrioventricular nodal reentrant tachycardia [6]. We report a case of CS ostial atresia with anomalous venous drainage into PLSVC with a left-sided accessory pathway (AP) that was successfully eliminated by catheter ablation
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