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: Patient successfully underwent implantation of CRT device with right atrial and ventricular leads placed via normal superior vena cava and the left ventricular lead placed via the PLSVC.
Take home message: Understanding coronary sinus anomalies is essential for successful interventions, highlighting the importance of proper evaluation and knowledge in this field.
JACC Case Reports Interim Editors-in-Chief
Gilbert H. L. Tang, MD, MSc, MBA
CME Editor
Kenneth A. Ellenbogen, MD
Author
Ahmad M. Slim, MD
Important Dates
Date of Release: August 6, 2025
Term of Approval/Date of CME/MOC Expiration: August 5, 2026