case_images: PMC11694703_01
case_images: Transoesophageal echocardiography (modified mid-oesophageal aortic valve short-axis view, A):atrial septal defect of 1.1 cm with almost no rim towards the aorta. Transthoracic echocardiography (modified long-axis view, B):dilated coronary sinus can be seen in the left atrium. Computed tomography (coronary plane, C; sagittal plane, D):persistent left superior vena cava with opening into a dilated coronary sinus and agenesis of the right superior vena cava. AAo, ascending aorta; AV, aortic valve; LA, left atrium; LV, left ventricle; MPA, main pulmonary artery; RA, right atrium; RV, right ventricle.
case_images: ytae670f1.jpg
case_images: PMC11694703_01_ytae670f1.jpg
case_images: ytae670-F1
case_images: Echocardiography revealed an atrial septal defect (ASD) of the secundum type (ASD II) (Figure 1A); a secondary finding was a significantly enlarged coronary sinus (CS) (Figure 1B). However, the anatomy of the ASD did not prove suitable (Figure 1A); there was only an inadequate aortic rim, and the required device size was inappropriate for the patient's septal diameter and adjacent cardiac structures. Computed tomography was performed before elective surgical closure of the ASD II to confirm the echocardiographic diagnosis of a pLSVC with agenesis of the right SVC (Figure 1C and D).