Key result
In a 29-year-old patient with congenitally corrected transposition of the great arteries and a severe malformation of the coronary venous system, three accessory pathways were successfully ablated.
Case Report (n=1)
This case report provides the first description of a severe malformation of the coronary venous system featuring multiple coronary sinus rings and a dual coronary venous system in a patient with CCTGA.
Ablation feasible despite venous anomalies in CCTGA; extends first dual coronary sinus description but leaves generalizability open.
A 29-year-old patient diagnosed with (S,L,L) congenitally corrected transposition of great arteries (CCTGA) and pre-excitation is presented. We performed a coronary angiogram and it documented multiple coronary sinus rings in both mitral and tricuspid atrioventricular grooves, with multiple branches and right atrium fistulas. Note the venous retour shows a dual coronary venous system, with a remnant of the left superior venacava draining in the ‘left’ coronary sinus (white arrows) marking the level of the true AV groove, and a prominent ‘right’ coronary venous system at the ‘right’ AV groove fistulas (red arrow). Three accessory pathways were ablated. To our knowledge, this severe malformation of the coronary venous system has not been previously described. The full-length version of this report can be viewed at: http://www.escardio.org/communities/EHRA/publications/ep-case-reports/Documents/multiple-accessory-pathways.pdf
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Hernández‐Madrid et al. (2013) conducted a case report in Congenitally corrected transposition of great arteries (CCTGA) and pre-excitation (n=1). Ablation of accessory pathways was evaluated. In a 29-year-old patient with congenitally corrected transposition of the great arteries and a severe malformation of the coronary venous system, three accessory pathways were successfully ablated.
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