Total Coronary Vein–Left Atrial Drainage

Abstract

An asymptomatic 54-year-old man with severe mitral regurgitation caused by prolapse and pulmonary hypertension was referred for mitral valve surgery. The resting ECG (Figure 1) and chest radiograph (Figure 2) were unremarkable. A transesophageal echocardiogram showed a degenerated mitral valve with rupture of chordae tendineae and leaflet prolapse causing severe mitral regurgitation (Figure 3). Figure 1. Resting ECG. Sinus tachycardia and otherwise unremarkable findings. Figure 2. Posteroanterior and lateral chest radiograph. Normal cardiac contours and normal pulmonary vasculature and parenchyma. A vertebral prosthesis is noted. Figure 3. Preoperative transesophageal echocardiogram. Doppler image showing a wide and eccentric jet of mitral regurgitation. Preoperative computed tomographic coronary angiography demonstrated normal coronary arteries; however, all cardiac veins were found to drain into the left …