IMAGES IN THIS ISSUE Cardiovascular Disorders http://dx.doi.org/10.3346/jkms.2016.31.8.1179 • J Korean Med Sci 2016; 31: 1179-1180
Anomalous Middle Cardiac Vein Draining into the Left Atrium
Jihyun Sohn,1 Young Soo Lee,2 Seung Pyo Hong,2 and Sung Hee Mun3
1Department of Cardiology, Kyungpook National University Hospital, Daegu, Korea; 2Department of Cardiology, Catholic University of Daegu, Daegu, Korea; 3Department of Radiology, Catholic University of Daegu, Daegu, Korea
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Fig. 1. Cardiac computed tomography demonstrates the middle cardiac vein draining into the left atrium (yellow arrows). (A-C) Axial serial scan images of cardiac computed to- mography after contrast dye injection. (D) The 3-dimensional volume rendering image of cardiac computed tomography. (E) The curved planar reformation image of cardiac computed tomography.
A 67-year-old woman was admitted for radiofrequency catheter oxygen supplement. Her electrocardiogram, chest X-ray, and ablation (RFCA) of paroxysmal atrial fibrillation. She had un- echocardiogram were within normal limits. She underwent derwent patch closure of atrial septal defect 7 years before. Her cardiac computed tomography for the left atrial reconstruction arterial blood oxygen saturation level was 94.6% without any before the RFCA. It revealed abnormal drainage of the middle
© 2016 The Korean Academy of Medical Sciences. pISSN 1011-8934 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. eISSN 1598-6357 Sohn J, et al. • Anomalous Middle Cardiac Vein Draining into the Left Atrium
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Fig. 2. CARTO® images clearly demonstrating the abnormal drainage of the middle cardiac vein into the left atrium (yellow arrows). (A) A 3-dimensional reconstructed image of the left atrium and pulmonary veins using CARTO®. (B) The 3D reconstructed image of both the atrium and pulmonary veins using CARTO®. cardiac vein into the left atrium (Fig. 1). The other cardiac veins Seung Pyo Hong http://orcid.org/0000-0002-0028-9647 including the great cardiac vein and small cardiac vein drained Sung Hee Mun http://orcid.org/0000-0002-8700-2513 into the coronary sinus normally. While she underwent RFCA, the abnormal drainage of the middle cardiac vein was also con- REFERENCES firmed in the CARTO® image (Fig. 2). An anomaly of the cardiac vein has rarely been reported. Previously reported venous anom- 1. Akkaya S, Ardalı S, Balcı S, Hazirolan T. Left atrial drainage of the great aly of the heart was anomaly of the great cardiac vein (1) or to- cardiac vein. J Cardiovasc Comput Tomogr 2015; 9: 225-6. tally abnormal drainage of the cardiac veins (2). This is a unique 2. Pizarro G, Castillo JG, Gaztanaga J, Garcia MJ. Images in cardiovascular case of an isolated anomalous drainage of the middle cardiac medicine. Total coronary vein-left atrial drainage. Circulation 2009; 120: vein into the LA without any anomaly of the coronary sinus. 914-7.
ORCID Address for Correspondence: Young Soo Lee, MD Department of Cardiology, Catholic University of Daegu, Jihyun Sohn http://orcid.org/0000-0001-5543-9633 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea Young Soo Lee http://orcid.org/0000-0002-8229-8300 E-mail: [email protected]
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