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  • Title: Surgical approach to left ventricular inflow obstruction due to dilated coronary sinus.
    Author: Vargas FJ, Rozenbaum J, Lopez R, Granja M, De Dios A, Zarlenga B, Flores E, Fischman E, Kreutzer E.
    Journal: Ann Thorac Surg; 2006 Jul; 82(1):191-6. PubMed ID: 16798213.
    Abstract:
    BACKGROUND: Left superior vena cava draining to a dilated coronary sinus can cause left ventricular inflow obstruction. Our purpose is to report 4 severely ill patients with this malformation who were operated upon and in whom repair was accomplished using an original surgical approach. METHODS: An operative procedure was designed, which included complete resection of the wall of the coronary sinus along its entire extension in the left atrium; division of the left superior vena cava; and establishment of the left superior vena cava-right atrial continuity by a wide left superior vena cava-right atrial appendage anastomosis. The series included 1 patient with interrupted inferior vena cava-hemiazygous continuation to left superior vena cava. RESULTS: There were no deaths. Absence of residual left ventricular inflow obstruction was demonstrated at follow-up in all cases, together with an unobstructed left superior vena cava-right atrial appendage-right atrial connection. CONCLUSIONS: A predictable relief of the left ventricular inflow obstruction, together with preservation of an adequate drainage for the systemic venous return, were both achieved with this repair.
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