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Case Reports
. 2023 Oct 6:26:102039.
doi: 10.1016/j.jaccas.2023.102039. eCollection 2023 Nov 15.

Late Outcome of a Left-Atrial-to-Coronary-Sinus Shunt

Mario D Bassi  1 , Kenza Rahmouni  2 , Alexandros Nantsios  2 , David Messika-Zeitoun  3 , Benjamin Hibbert  3 , Talal Al-Atassi  2 , Vincent Chan  2
Affiliations
Case Reports

Late Outcome of a Left-Atrial-to-Coronary-Sinus Shunt

Mario D Bassi et al. JACC Case Rep. .

Abstract

Frail patients with severe calcific mitral stenosis have few treatment options. We present a novel case successfully treated with a left-atrial-to-coronary-sinus shunt. However, the patient's symptoms returned, and, at surgery, the shunt was found to be occluded and associated with left atrial and ventricular fibrosis and calcification. (Level of Difficulty: Intermediate.).

Keywords: coronary sinus shunt; heart failure; mitral annulus calcification; mitral regurgitation; mitral stenosis; valve fibrosis.

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Conflict of interest statement

Dr Hibbert is a consultant for Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Computed Tomography Images of Calcification of LV and Mitral Valve (A) Axial view of thorax showing extent of mitral annulus calcification. (B) Alternative axial view of the thorax showing significant LV calcification due to shunt insertion from coronary sinus to left atrium. (C) Coronal view of thorax showing the degree of LV calcification. (D) Sagittal view of thorax showing breadth of LV mural and mitral calcification. LA = left atrium; LV = left ventricle.
Figure 2
Figure 2
Intraoperative View of Left-Atrium-to-Coronary-Sinus Shunt Image taken in operating room from an axial perspective, showing coronary sinus shunt (∗) in center along with surrounding left ventricular calcification.
See this image and copyright information in PMC

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