Coronary artery fistulas represent abnormal connections between the coronary arterial system and cardiac chambers or other vascular structures. Depending on various morphological characteristics of the fistula, the clinical presentation may vary from being asymptomatic to having clinically significant myocardial ischemia. The present case highlights a rare instance of a right coronary artery to coronary sinus fistula with a giant coronary sinus aneurysm.

Coronary sinus thrombosis (CST) is rare, and consensus on optimal treatment remains elusive. This article details the presentation and management of a large CST in a 73-year-old female patient. Notably, the case involves persistent left superior vena cava (PLSVC), a rare congenital anomaly complicating the scenario. The patient was successfully treated with on-pump surgery and postoperative anticoagulant therapy. Our findings advocate for a comprehensive understanding of CST, highlighting potential efficacy in combined surgical and anticoagulant strategies, particularly in cases with PLSVC. This underscores the necessity for further research to refine diagnostic and treatment approaches for complex CST scenarios.

Unraveling the mechanisms of a giant coronary sinus.

Coronary sinus aneurysm is a rare heart anomaly. Herein, we report a rare case with giant coronary sinus aneurysm misdiagnosed as an extracardiac mediastinal tumor. The preoperative diagnostic imaging failed to diagnose the correct location of the tumor and a simple resection was planned. It turned out to be coronary sinus aneurysm intraoperatively and required cardiopulmonary bypass support for the resection.

A 41-year-old female, who had undergone balloon mitral valvotomy 4 years back, presented with Class 3 dyspnoea. She had elevated jugular venous pressure up to the angle of mandible with pedal oedema. An echocardiogram showed severe mitral valve disease with severe tricuspid regurgitation with dilated right atrium. The tricuspid …

Mini‐AbstractCoronary sinus dilatation is usually the result of anomalous drainage to the sinus, either from the persistent left superior vena cava, anomalous pulmonary vein drainage or from coronary arterio‐venous fistula. Occasionally, the degree of coronary sinus enlargement is so great that the structure is mistaken for something else, such as accessory cardiac chamber or dilated descending aorta. Herein, we describe a rare case of giant coronary sinus that has an unusual enlargement as cardiac chamber.

Isolated persistent left-sided superior vena cava, giant coronary sinus, atrial tachycardia and heart failure in a child

Persistent left superior vena cava associated with giant coronary sinus

Although persistent left superior vena cava (PLSVC) is rare, it is the most common thoracic venous anomaly. The prevalence of PLSVC is 0.3 % in a general population and 10 % in patients with congenital heart disease. Diagnosis of PLSVC is usually incidental during cardiovascular imaging or surgery. Although PLSVC is usually not associated with any negative hemodynamic effect, it is important to be aware of its existence, since it may cause problems in central venous catheterization, pacemaker implantation and cardiopulmonary bypass. The overall proportion of absent right superior vena cava in patients with PLSVC is approximately 20 %. If PLSVC is associated with absence of the right superior vena cava, the coronary sinus may become gigantic due to excessive inflow. Herein, we report a case of PLSVC complicated by the absence of a right superior vena cava resulting in a giant coronary sinus.

We report a case of persistent left superior caval vein whom presented with angina pectoris and exertional dyspnea. Echocardiography showed wall motion disturbances with an ejection fraction of 40% and a very large coronary sinus. Our case is a very rare case with a very large coronary sinus presented with angina pectoris.

Origin of a mysterious left atrial V wave

Concomitant giant coronary artery and coronary sinus aneurysms

Russo, Vincenzo; De Crescenzo, Ilaria; Ammendola, Ernesto; Ferrara, Ilaria; Lassandro, Francesco; Russo, Gabriella; Santangelo, Lucio; Calabrò, Raffaele Author Information

Giant Coronary Sinus Caused by Absent Right and Persistent Left Superior Vena Cava and Severe Tricuspid Regurgitation

Noninvasive evaluation of a fistula between a giant coronary aneurysm and coronary sinus performed via multidetector row computed tomography

Giant coronary sinus diverticulum with persistent left superior vena cava demonstrated by multislice computed tomography

Left Aortic Arch and Right Superior Vena Cava in Mirror-Image Dextrocardia with Tetralogy