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Surgical Management of Unroofed Coronary Sinus Syndrome: A 20-Year-Single-Center Experience In 159 Patients
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  • Hao Shi,
  • Jun Yan,
  • Qiang Wang,
  • Zhongdong Hua,
  • Shoujun Li,
  • Jing Zhang
Hao Shi
Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital
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Jun Yan
Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital
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Qiang Wang
Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital
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Zhongdong Hua
Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital
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Shoujun Li
Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital
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Jing Zhang
Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital
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Abstract

Background. Unroofed coronary sinus syndrome (UCSS) is rare and often associated with Left superior vena cava (LSVC). We report our experience in 159 patients with UCSS during a 20-year period in terms of clinical features, diagnosis, associated anomalies, surgical procedures and late outcomes. Methods. Between May 1998 and May 2019, 159 patients with UCSS were treated surgically and followed up. UCSS was confirmed by preoperative echocardiography or CT scan in 97 patients and by the surgeons during surgery in 62. LSVC directly drained into the left atrium (LA) was found in 100 cases. In these patients, 8 cases of LSVC were ligated, 59 cases were reconstructed the intracardiac tunnel to drain LSVC to right atrium (RA), and the extracardiac procedure was constructed to lead the LSVC draining to RA in 2. The associated cardiac lesions were corrected concomitantly. Results There were 5 hospital deaths. We followed up 143 early survivors, and there was no death. Except for one case of avulsion of the patch in which LSVC was drained by internal tunnel, there were no serious complications in other follow-up patients. Conclusion. UCSS is often misdiagnosed in the preoperative evaluation of congenital heart diseases. Preoperative transthoracic echocardiography (TTE) is still the most important method in the diagnosis of UCSS. When associated with LSVC, UCSS should be considered as a possible additional finding.We performed different surgical approaches to deal with the different types of UCSS with LSVC with a good result.

Peer review status:UNDER REVIEW

21 Apr 2020Submitted to Journal of Cardiac Surgery
21 Apr 2020Submission Checks Completed
21 Apr 2020Assigned to Editor
21 Apr 2020Reviewer(s) Assigned
25 Apr 2020Review(s) Completed, Editorial Evaluation Pending
25 Apr 2020Editorial Decision: Revise Major
13 May 20201st Revision Received
29 May 2020Submission Checks Completed
29 May 2020Assigned to Editor
29 May 2020Reviewer(s) Assigned
31 May 2020Review(s) Completed, Editorial Evaluation Pending
31 May 2020Editorial Decision: Revise Major
01 Jul 20202nd Revision Received
01 Jul 2020Submission Checks Completed
01 Jul 2020Assigned to Editor
01 Jul 2020Reviewer(s) Assigned
02 Jul 2020Review(s) Completed, Editorial Evaluation Pending
02 Jul 2020Editorial Decision: Revise Minor
01 Aug 20203rd Revision Received
01 Aug 2020Assigned to Editor
01 Aug 2020Submission Checks Completed
01 Aug 2020Reviewer(s) Assigned
07 Aug 2020Review(s) Completed, Editorial Evaluation Pending
08 Aug 2020Editorial Decision: Revise Major
23 Sep 20204th Revision Received
23 Sep 2020Assigned to Editor
23 Sep 2020Submission Checks Completed
23 Sep 2020Reviewer(s) Assigned