Coronary sinus diverticula appear as an outpouching connected to the coronary sinus. Although an uncommon finding, coronary sinus diverticulum is a well-recognized cause of ineffective ablation of the accessory pathway in Wolff-Parkinson-White syndrome (Figs 1 and 2), underscoring the need for identification and reporting. In such cases, an alternative operative approach with division of the diverticulum neck may be prompted to treat the accessory pathway (1–4).
Figure 1:
Cardiac CT angiographic findings show a coronary sinus diverticulum in an 84-year-old male patient with history of Wolff-Parkinson-White syndrome and previous unsuccessful attempts to ablate the accessory pathway. Parasagittal section (two-chamber view) from a volume-rendered three-dimensional reconstruction shows a saccular contrast material–filled formation along the inferior atrioventricular groove (straight white arrows) communicating with the coronary sinus (curved dashed arrow), compatible with a coronary sinus diverticulum. Although an uncommon finding, it is a well-recognized cause of ineffective ablation of the accessory pathway in Wolff-Parkinson-White syndrome, underscoring the need for identification and reporting. In such cases, an alternative operative approach with division of the diverticulum neck may be prompted to treat the accessory pathway (1–4).
Figure 2:
Cardiac CT angiographic data set. Saccular dilatation of the coronary sinus along the inferior atrioventricular groove, incidental bicuspid aortic valve with thickened and calcified leaflets, and associated dilatation of the ascending aorta are shown. (Full DICOM image stacks are available for Fig 2.)
Footnotes
Disclosures of Conflicts of Interest: E.K.U.N.F. disclosed no relevant relationships. L.R.P.D.S. disclosed no relevant relationships.
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