Resynchronization Therapy in a Coronary Venous Sinus Anomaly.

ANATOMY

Coronary venous sinus is the major portal for cardiac venous drainage and plays a crucial role in electrophysiological procedures like left ventricular pacing.

PATHOLOGY

Although congenital anomalies of the coronary sinus are rare, we present a unique case of interrupted coronary sinus. The proximal segment drained normally into the right atrium, while the distal segment drained into a common channel that connected to the left subclavian vein via a persistent left superior vena cava.

IMAGING CORRELATION

This anomaly was initially suspected during Levo-phase coronary sinus angiography and further confirmed by computed tomography and direct coronary sinus angiography.

TREATMENT

The patient successfully underwent implantation of a cardiac resynchronization therapydevice with right atrial and ventricular leads placed via normal superior vena cava, and the left ventricular lead placed via the persistent left superior vena cava.

TAKE-HOME MESSAGE: Understanding coronary sinus anomalies is essential for successful interventions, highlighting the importance of proper evaluation and knowledge in this field.