Surgical Management of Unroofed Coronary Sinus Syndrome: A
20-Year-Single-Center Experience In 159 Patients
Running head Unroofed Coronary Sinus Syndrome
Hao Shi, Jun Yan, Qiang Wang, Zhongdong Hua, Shoujun Li, Jing Zhang
Department of Pediatric Cardiac Surgery, National Center
for Cardiovascular Disease and Fuwai Hospital, Chinese Academy
of Medical Sciences, Peking Union Medical College, 167 Beilishi Road,
Xicheng, Beijing 100037, People’s Republic of China
Corresponding author: Jing Zhang. E-mail:zhangjingfw@163.com.
【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.
【Key words 】Unroofed coronary sinus; Cardiac surgical
procedures; Left superior vena cava; Echocardiography; Congenital heart
disease