Department of Surgery, Division of Cardiac Surgery, Kingston General Hospital, Queens University, Kingston, Ontario, Canada.
Ann Thorac Surg. 2012 Jan;93(1):296-7. doi: 10.1016/j.athoracsur.2011.06.076.
A patient with combined aortic insufficiency and stenosis underwent aortic valve replacement. After weaning off cardiopulmonary bypass, a new shunt into the left atrium was noted that had not been apparent on multiple previous echocardiographs. Using an agitated saline test, we confirmed a shunt between the coronary sinus and left atrium. The assumption was made that there had been an iatrogenic fistula created with placement of the retrograde catheter; however, upon opening the left atrium it was realized that the patient had a previously undiagnosed, congenitally unroofed coronary sinus. It was repaired primarily and the patient had an uneventful recovery.
一位同时患有主动脉瓣关闭不全和狭窄的患者接受了主动脉瓣置换术。在心肺转流脱机后，我们注意到一个新的左心房分流，而这在之前的多次超声心动图中都没有明显显示。使用含生理盐水的超声心动图，我们证实了冠状窦和左心房之间的分流。假设这是由于逆行导管放置导致医源性瘘；然而，打开左心房后，我们发现患者有一个以前未诊断出的、先天性冠状窦顶缺失。我们对其进行了一期修复，患者恢复顺利。
