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Misdiagnosis of unroofed coronary sinus syndrome as an ostium primum atrial septal defect by echocardiography:A case report

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World Journal of Clinical Cases 2022年第5期10卷 1592-1597页

作者： Jin-Ling Chen Cai-Gui Yu Dai-Jiao Wang Hong-Bin Chen Department of Echocardiography Renmin Hospital of Wuhan UniversityWuhan 430060Hubei ProvinceChina Department of Pulmonary and Critical Care Medicine Renmin Hospital of Wuhan UniversityWuhan 430060Hubei ProvinceChina

BACKGROUND Unroofed coronary sinus syndrome(UCSS)is a rare congenital heart disease,which has variable morphologic features and is strongly associated with persistent left superior vena cava(PLSVC).However,it is often difficult to visualize the left-to-right shunt pathway through the CS by transthoracic echocardiography(TTE).CASE SUMMARY A 37-year-old female was admitted to the hepatological surgery department of a hospital with complaint of subxiphoid pain that had started 1 wk *** examination revealed a grade 3/6 systolic murmur at the left margin of the sternum,between the 2nd and 3rd intercostal *** patient underwent echocardiography and was diagnosed with ostium primum atrial septal defect(ASD);thus,she was subsequently transferred to the cardiovascular surgery department.A second TTE evaluation before surgery showed type IV UCSS with secundum ***-heart contrast echocardiography(RHCE)showed that the right atrium and right ventricle were immediately filled with microbubbles,but no microbubble was observed in the ***,negative filling was observed at the right atrium orifice of the CS and right atrium side of the secundum atrial *** identified UCSS combined with secundum ASD but without PLSVC in this *** This rare case of UCSS highlights the value of TTE combined with RHCE in confirming UCSS with ASD or PLSVC.

关键词： Congenital heart disease coronary sinus Atrial septal defect Persistent left superior vena cava Echocardiography Right heart contrast echocardiography Case report

Temporary coronary sinus pacing to improve ventricular dyssynchrony with cardiogenic shock: A case report

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World Journal of Clinical Cases 2021年第20期9卷 5562-5567页

作者： Teressa Reanne Ju Hsin Tseng Hsin-Ti Lin Alexander Lee Wang Chi Chan Lee Yi-Ching Lai Department of Internal Medicine NewYork-Presbyterian Queens HospitalQueensNY 11355United States School of Medicine China Medical UniversityTaichung City 40447Taiwan Department of Critical Care Medicine Guam Regional Medical CityDededo 96929Guam Department of Cardiology Division of Internal MedicineChina Medical University HospitalTaichung City 40447Taiwan

BACKGROUND Temporary transvenous pacing through the coronary sinus is a novel approach rarely used in treating unstable *** modality could provide cardiac pacing while achieving better ventricular *** present a case who received cardiac pacing through the coronary sinus and provide a summary of evidence in the current *** SUMMARY A 55-year-old woman with a history of advanced heart failure was admitted to the rehabilitation ward after a recent *** hospitalization,she had paroxysmal atrial fibrillation with rapid ventricular response resulting from fluid *** atrial fibrillation was spontaneously reversed to sinus rhythm after diuresis,she developed multiple episodes of polymorphic ventricular tachycardia along with sinus bradycardia and prolonged QTc *** became hypotensive despite appropriate medical *** through her implantable cardioverter-defibrillator was attempted but worsened her *** dyssynchrony was *** transvenous atrial pacing through the coronary sinus was performed,which stabilized her blood pressure and improved end-organ perfusion.A permanent biventricular pacemaker was later implanted,and she was safely discharged to a nursing *** Temporary transvenous pacing through the coronary sinus,a novel approach to treat unstable bradycardia,may reduce ventricular dyssynchrony.

关键词： Cardiac resynchronization Artificial pacemaker coronary sinus Heart failure Cardiogenic shock Case report

coronary sinus： an important target of catheter ablation of atrial fibrillation

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Chinese Medical Journal 2009年第23期122卷 2912-2913页

作者： ZHANG Ming LI Zhi-zhong LIU Xin-peng DONG Jian-zeng MA Chang-sheng Department of cardiology Beijing Anzhen Hospital CapitalMedical University Beijing 100029 China

The pulmonary veins have been demonstrated to be the major source of atrial fibrillation （AF）. Isolation of the pulmonary veins is effective in curing patients with paroxysmal AE However, this strategy is associated with limited success in some patients with paroxysmal AF and in most patients with persistent and permanent AF It requires more widespread ablation targeting most parts of the left atrial and thoracic veins and may include some discrete sites, which, if missed or neglected, can lead to persistence of fibrillation. In recent years, other AF origins have also been reported in addition to some types of atrial tachycardia and AF originating from the coronary sinus （CS） musculature. The CS appears to be a major element perpetuating persistent AF.

关键词： coronary sinus atrial fibrillation catheter ablation

Value of coronary sinus During Computed Tomography Pulmonary Angiography for Predicting Pulmonary Hypertension in Patients with Acute Pulmonary Embolism

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Cardiology Discovery 2023年第2期3卷 78-84页

作者： Chuang Zhang Qian Xin Hongling Xu Xiangyu Wang Zhiqiang Yan Shengtao Sun Xiangmin Shi Mei Tian Department of Cardiology The Sixth Medical Center of People’s Liberation Army General HospitalBeijing 100048China Department of Cardiology The Eighth Medical Center of People’s Liberation Army General HospitalBeijing 100091China Department of Radiology The Eighth Medical Center of People’s Liberation Army General HospitalBeijing 100091China Department of Radiology The Sixth Medical Center of People’s Liberation Army General HospitalBeijing 100048China.

Objective:Computed tomography pulmonary angiography(CTPA)parameters are valuable for predicting pulmonary hypertension(PH)in patients with pulmonary embolism(PE).However,few studies have used the coronary sinus ostium area(CSOA),derived from CTPA,to detect *** study aimed to compare the prognostic values of the CSOA,coronary sinus ostium diameter(CSOD),and right ventricular(RV)/left ventricular(LV)ratio for ***:This study retrospectively analyzed 78 patients(mean age,(51.94±12.33)years;53.8%male)with acute PE confirmed by CTPA at the Sixth and Eighth Medical Centers of the People’s Liberation Army General Hospital between June 2018 and June *** were categorized into 2 groups using a pulmonary artery systolic pressure(PASP)cut-off of 30 *** parameters were compared between these ***:Patients with PASP>30 mmHg(n=22)had a larger CSOA,CSOD,RV diameter,RV/LV ratio,and inferior vena cava diameter compared with patients with PASP≤30 mmHg(n=56).The CSOA had an area under the receiver-operating characteristic curve(AUC,0.84;95%confidence interval(CI),0.74–0.94;P30 mmHg.

关键词： Angiography Computed tomography coronary sinus Diagnosis Pulmonary embolism Pulmonary hypertension Right ventricle

Radiofrequency ablation of a unique coronary sinus connected accessory pathway with ventricular insertion far away from mitral annulus

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Radiofrequency ablation of a unique coronary sinus connected...

Accidental venous port placement via the persistent left superior vena cava:Two case reports

2015年浙江省心电生理与起搏学术年会

作者： Fangyi Xiao Weijian Huang Lei Xu Haiying Li From Cardiac Center the First Affiliated Hospital of Wenzhou Medical University

Typical accessory pathways(APs)usually have the ventricular insertion sites close to atrioventricular(AV)annuli and possess non-decremental conduction *** or atrioventricular(Mahaim)fibers may have the distal insertion sites far away from annulus and possess decremental anterograde-only conduction *** report a rare case of an epicardial left free-wall AV fiber with ventricular insertion at lateral wall of left ventricle far away from mitral annulus with manifested non-decremental conduction ***,the retro-

关键词： accessory pathway radiofrequency ablation coronary sinus

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World Journal of Clinical Cases 2022年第27期10卷 9879-9885页

作者： Rui-Na Zhou Xiao-Bin Ma Li Wang Hua-Feng Kang Department of Oncology The Second Affiliated Hospital of Xi’an Jiao Tong UniversityXi'an 710004Shaanxi ProvinceChina

BACKGROUND Breast cancer poses a great threat to females *** are various therapies available to cure this common disease,such as surgery,chemotherapy,radiotherapy,and *** venous access ports(IVAP,referred to as PORT)have been widely used for breast cancer *** malformations are possible conditions encountered during PORT *** left superior vena cava(PLSVC)is a common superior vena cava *** patients have normal right superior vena cava without affecting hemodynamics,so patients often have no obvious *** SUMMARY We incidentally found that two patients had PLSVC while a PORT was implanted via the internal jugular *** to chemotherapy for breast cancer,PORT was successfully implanted under the guidance of ultrasound into these 2 *** chest X-ray examination after the operation showed that the catheter ran beside the left mediastinum and the end was located in the seventh thoracic *** patients had no catheter-related complications and successfully completed the course of *** found that the ratio of PORT outer diameter to PLSVC inner diameter was less than 0.45,which was in line with the recommendations of relevant literature and operating *** purpose of this article is to introduce two rare cases and review the relevant *** Correct assessment of PLSVC status and ultrasound-guided PORT placement generally does not affect breast cancer patients chemotherapy.

关键词： Implantable venous access port Persistent left superior vena cava Chemotherapy coronary sinus Case report

Cardiac tamponade as a rare complication after giant coronary fistula percutaneous closure

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World Journal of Cardiovascular Diseases 2013年第2期3卷 215-217页

作者： Pablo Diez Villanueva Fernando Sarnago Cebada Enrique Gutierrez Ibanes Ricardo Sanz-Ruiz Jaime Elizaga-Corrales Francisco Fernandez-Aviles Cardiology Department Hospital General Universitario Gregorio MaranonMadridSpain

We present the case of an unusual complication after percutaneous closure of a giant coronary artery fis-tula. A 76-year-old man with previous admissions due to right heart failure and previous history of atrial fibrillation under acenocumarol, was admitted to our hospital for new onset of symptoms, characterized by progressive dyspnoea and peripheral edema. Physical examination revealed signs of congestive heart failure and a continuous murmur loudest along the lower sternal border. X-Ray showed cardiomegaly due to right chambers dilatation. Transthoracic echocardiography showed right chambers pressure and volume overload, with right ventricular enlargement and dysfunction, tricuspid annulus dilatation and severe tricuspid regurgitation. Cardiac catheterization showed significant elevation of right atrial pressure, as well as significant step-up of oxygen saturation in this chamber. coronary angiography revealed the presence of a large fistula between the circumflex coronary artery (CCA) and coronary sinus (CS), with severe dilation of the CCA (maximum diameter20 mm). An Amplatzer? PDA was implanted in a distal elbow of the fistula with initailly good results. Anticoagulant therapy was then reinitiated, and a few days later, the patient developed clinical worsening of heart failure and dyspnoea. Echocardiogram showed significant pericardial effusion. Pleuropericardial window was then made draining a500 cm3 of bloody pericardial effusion. The postoperative outcome was excellent, with symptomatic relief and no signs of heart failure.

关键词： Giant coronary Fistula Circumflex coronary Artery coronary sinus Percutaneous Transcatheter Closure Pericardial Effusion Cardiac Tamponade