Author + information
- Received May 16, 2010
- Accepted July 5, 2010
- Published online February 22, 2011.
A 49-year-old woman with a history of cryptogenic brain abscess was referred for suspicion of atrial septal defect and/or patent foramen ovale on the basis of findings from a transthoracic echocardiogram. Cardiovascular magnetic resonance cine imaging showed absence of the coronary sinus in its usual position in the inferior atrioventricular groove (A and B; usual location of coronary sinus on inferior surface of left atrioventricular groove marked by ✚), with the opening to the right atrium (RA) present (“unroofed” coronary sinus; opening into RA marked by arrowhead), and suggested a persistent left superior vena cava (PLSVC) draining into left atrial (LA) appendage (location marked by ✽). Phase-contrast flow measurement revealed a net left to right shunt (Qp/Qs ratio 1.4). Three-dimensional contrast-enhanced magnetic resonance angiogram confirmed the presence of persistent left superior vena cava draining into the LA appendage, along with a right superior vena cava (RSVC) draining normally into the RA (C, D, and E, Online Video 1). The constellation of findings of unroofed coronary sinus associated with a persistent left superior vena cava draining to the LA appendage is known as the Raghib complex. Ao = aorta; LV = left ventricle.
- Received May 16, 2010.
- Accepted July 5, 2010.
- American College of Cardiology Foundation