Surgical treatment of total left anomalous pulmonary venous connection to the coronary sinus without atrial septal defect

Surgical repair of total left anomalous pulmonary venous connection to coronary sinus without atrial septal defect (ASD), a very rare situation, was recently conducted. A 13-year-old girl was diagnosed as ASD. Two-dimensional echocardiography, however, indicated enlarged coronary sinus preoperatively. During operation the absence of ASD and drainage of total left pulmonary veins into the coronary sinus were observed. The operation was conducted by the method of Van-Praagh. The coronary sinus was closed to divert pulmonary venous blood to the left atrium, while maintaining coronary venous return to the right atrium. The postoperative course was uneventful and cardiac catheterization showed satisfactory results.