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Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
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Table of Contents
VIDEO COMMENTARY 2  
Year : 2015  |  Volume : 18  |  Issue : 2  |  Page : 216
Video Commentary on "Imaging the coronary sinus"


1 Department of Cardiac Anaesthesia, C.N. Centre, AIIMS, New Delhi, India
2 Department of Surgery, C.N. Centre, AIIMS, New Delhi, India

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Date of Web Publication2-Apr-2015
 

How to cite this article:
Irpachi K, Kapoor PM, Narula J, Sahu M. Video Commentary on "Imaging the coronary sinus". Ann Card Anaesth 2015;18:216

How to cite this URL:
Irpachi K, Kapoor PM, Narula J, Sahu M. Video Commentary on "Imaging the coronary sinus". Ann Card Anaesth [serial online] 2015 [cited 2020 Oct 27];18:216. Available from: https://www.annals.in/text.asp?2015/18/2/216/154483


  • A persistent PLSVC results from failure of the left anterior cardinal vein to obliterate.
  • It is the commonest variation in the anomalous venous return of the heart.
  • Dilated Coronary sinus on ECHO confirmed by saline contrast echocardiography.
  • Increased likelihood of CHD if there is no right-sided SVC or if the LSVC drains into the left atrium (LA).
  • TEE is more accurate in visualizing these posterior cardiac structures and provides better delineation of coronary sinus.
  • Coronary sinus diameter - 6.6 ΁ 1.54-10




Coronary sinus width > 2cm is suggestive of LSVC

  • LSVC drains directly into the CS leading to CS dilation
  • "Bubble study" from left upper extremity will demonstrate CS contrast followed by RA contrast
  • A negative bubble contrast test does not exclude the possibility of a left SVC, since a large in nominate vein and small left SVC can coexist.
  • Standard TEE Views for Coronary Sinus are:
    • ME coronary sinus view
    • ME 2 chamber view
    • ME modified bicaval view
    • TG basal short axis view (coronary sinus view)


Atypical LSVC drainage into the LA results in :-

  • A right to left shunt,
  • cyanosis,
  • paradoxical thromboembolism,
  • air and septic embolism





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