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Transthoracic echocardiography (TTE) revealed this rare venous anomaly, which is mainly reported in the older population and primarily as an incidental finding. TTE with an agitated saline study was the key diagnostic modality. Early diagnosis is crucial given the potential complications of thromboembolic phenomena and brain abscesses. Clinical suspicion should be high in neonates with persistent unexplained oxygen requirements with a structurally normal heart, primarily when associated with PLSVC. This is the first-ever case report of UCS presenting in the neonatal period.<\/jats:p>","DOI":"10.1136\/bcr-2025-270128","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:40:25Z","timestamp":1769697625000},"page":"e270128","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unroofed coronary sinus and persistent left superior vena cava: a rare neonatal venous anomaly"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2752-6136","authenticated-orcid":false,"given":"Min Charisse","family":"Yu","sequence":"first","affiliation":[{"name":"Neonatology, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan Tze Liang","family":"Choo","sequence":"additional","affiliation":[{"name":"KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lay Khim","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishna Revanna","family":"Gopagondanahalli","sequence":"additional","affiliation":[{"name":"KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"2026012906401502000_19.1.e270128.1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.11622\/smedj.2019167","article-title":"Screening for congenital heart disease in a Singapore neonatal unit","volume":"62","author":"Ngeow","year":"2021","journal-title":"Singapore Med J"},{"key":"2026012906401502000_19.1.e270128.2","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1111\/jocs.15269","article-title":"Surgical management of unroofed coronary sinus syndrome: A 20\u2010year\u2010single\u2010center experience","volume":"36","author":"Shi","year":"2021","journal-title":"J Card Surg"},{"key":"2026012906401502000_19.1.e270128.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.31.6.906"},{"key":"2026012906401502000_19.1.e270128.4","first-page":"899","article-title":"Coronary sinus defects: rare form of interatrial communication","volume":"85","author":"Bertram","year":"1996","journal-title":"Z Kardiol"},{"key":"2026012906401502000_19.1.e270128.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-5273(03)00042-1"},{"key":"2026012906401502000_19.1.e270128.6","unstructured":"Kirklin JW , Barratt-Boyes BG . 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