Suarez Keith, Banchs Javier E, Lazol Judith P, Black James N
Department of Cardiovascular Diseases, Baylor Scott and WhiteTempleTexas.
Department of Clinical Cardiac Pacing and Electrophysiology, Baylor Scott and WhiteTempleTexas.
Proc (Bayl Univ Med Cent). 2018 Sep 26;31(4):499-501. doi: 10.1080/08998280.2018.1491196. eCollection 2018 Oct.
A 13-year-old boy presenting with palpitations was diagnosed with Wolf-Parkinson-White syndrome. We elected to bring him to the electrophysiology lab for evaluation of the accessory pathway and potential ablation. Structural assessment of the coronary sinus with electro-anatomical mapping and retrograde venography led to the discovery of a great cardiac vein having a separate insertion from the coronary sinus into the high right atrium. The accessory pathway was localized to the left lateral portion of the mitral annulus and treated successfully with radiofrequency ablation. Such venous anatomical variant has been seldom reported, and its association with an accessory pathway is described here for the first time. Its recognition can have important implications when performing procedures that require access into the coronary venous system.
一名13岁出现心悸症状的男孩被诊断为预激综合征。我们决定将他带到电生理实验室，以评估其附加通路并进行可能的消融治疗。通过电解剖标测和逆行静脉造影对冠状静脉窦进行结构评估时，发现一条心大静脉从冠状静脉窦分出并单独开口于高位右心房。附加通路定位于二尖瓣环的左侧部分，并通过射频消融成功治疗。这种静脉解剖变异很少被报道，本文首次描述了它与附加通路的关联。认识到这一点在进行需要进入冠状静脉系统的手术时可能具有重要意义。
