Case of the Week: Top 5 2020 Competition-Diagnosis Of A Coronary Sinus Atrial Septal Defect By 4D Flow MRI

Diagnosis Of A Coronary Sinus Atrial Septal Defect By 4D Flow MRI

Video Transcription

Video Summary

A 15-year-old girl with right atrial and right ventricular enlargement and a dilated coronary sinus had an unclear atrial-level shunt on echocardiography. Cardiac MRI with 4D flow (“FortyFlow”) clarified the anatomy, showing no left superior vena cava, normal pulmonary venous return, and an unroofed coronary sinus with left-to-right shunting from the left atrium into the right atrium. The imaging guided surgical planning before repair with a pericardial patch. Postoperative imaging showed no significant residual shunt. The case highlights 4D flow MRI’s value in diagnosing coronary sinus ASD when echocardiography is inconclusive.

Keywords

coronary sinus ASD

4D flow MRI

atrial septal defect

right atrial enlargement

unroofed coronary sinus