CTICasesUnroofed Coronary Sinus Variant with Pulmonary Vein Communication
Imaging findings
CT shows an abnormal connection between the left superior pulmonary vein and the coronary sinus, with the coronary sinus communicating with the left atrium indirectly through the pulmonary vein rather than connecting directly. The finding resembles an unroofed coronary sinus, with anticipated left-to-right shunt flow carrying both coronary sinus and pulmonary venous return. The patient is older with atherosclerotic disease and non-dilated ventricles.
Key takeaways
This is an unusual variant in the spectrum of unroofed coronary sinus, in which the communication between the coronary sinus and left atrium is by way of the left superior pulmonary vein rather than a direct defect. The resulting shunt receives both coronary sinus and pulmonary venous flow, making it a somewhat larger left-to-right shunt, and recognizing the anomalous venous connection is the key point.
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