CTICasesAtretic Coronary Sinus in Tetralogy of Fallot
Imaging findings
Gated cardiac CT in a patient with Tetralogy of Fallot shows an atretic coronary sinus with no connection to the right atrium. The coronary venous system decompresses retrogradely via a large vertical vein into the left brachiocephalic vein.
Key takeaways
Atresia of the coronary sinus ostium is a rare congenital anomaly, often associated with other cardiac defects like Tetralogy of Fallot. Drainage of the coronary venous system must occur via collateral pathways, typically a persistent left vertical vein or coronary-to-pulmonary/atrial collaterals.
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