Journal of JCIC

We report successful percutaneous balloon angioplasty of an acquired coronary sinus orifice atresia (CSOA) using a chronic total occlusion (CTO) guidewire via retrograde approach. A 5-year-old girl presented with facial edema. Her past history includes partial atrioventricular septal defect and left superior vena cava (LSVC) with unroofed coronary sinus that were successfully repaired by surgery at 7 months of age. Left-hand peripheral venography showed CSOA and congestion in the LSVC. Though we tried to insert multipurpose catheter into the coronary sinus with a 0.035″ guidewire via antegrade approach, this was not success. Therefore, we choose a 0.012″ tip CTO guidewire to penetrate acquired CSOA via retrograde approach and could successfully recanalize the pathway to the LSVC by stepwise dilation with different sized balloons. Contrast echocardiography after treatment confirmed that good patency from LSVC to RA.