{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T14:15:43Z","timestamp":1774534543919,"version":"3.50.1"},"reference-count":7,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,3,5]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Unroofed coronary sinus (CS) with CS orifice atresia and persistent left superior vena cava (PLSVC) is an exceptionally rare congenital anomaly that may coexist with acquired valvular disease, as illustrated in this case of severe rheumatic mitral stenosis. Multimodality imaging including echocardiography and cardiac CT was essential for precise anatomical delineation, guiding safe surgical intervention. Recognition of this complex anatomy is critical to avoid catastrophic complications such as inadvertent PLSVC ligation without ensuring adequate CS drainage. This case highlights the importance of comprehensive preoperative imaging in managing combined congenital and acquired cardiac pathologies.<\/jats:p>","DOI":"10.1136\/bcr-2025-271489","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:35:28Z","timestamp":1774532128000},"page":"e271489","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rare coexistence of unroofed coronary sinus, coronary sinus atresia and rheumatic mitral stenosis demonstrated by multimodality imaging"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6864-4297","authenticated-orcid":false,"given":"Digvijay","family":"Nalawade","sequence":"first","affiliation":[{"name":"Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7244-437X","authenticated-orcid":false,"given":"Prakyath Prabhakar","family":"Shetty","sequence":"additional","affiliation":[{"name":"Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konark","family":"Thakkar","sequence":"additional","affiliation":[{"name":"Cardiovascular Thoracic Surgery, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anurag","family":"Garg","sequence":"additional","affiliation":[{"name":"Cardiovascular Thoracic Surgery, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susheel Kumar","family":"Malani","sequence":"additional","affiliation":[{"name":"Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"2026032606351840000_19.3.e271489.1","first-page":"497","article-title":"Surgical treatment of coronary sinus orifice atresia; report of a case","volume":"67","author":"Sato","year":"2014","journal-title":"Kyobu Geka"},{"key":"2026032606351840000_19.3.e271489.2","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1016\/j.crad.2012.07.013","article-title":"Multidetector CT and MRI of ostial atresia of the coronary sinus, associated collateral venous pathways and cardiac anomalies","volume":"67","author":"Shum","year":"2012","journal-title":"Clin Radiol"},{"key":"2026032606351840000_19.3.e271489.3","doi-asserted-by":"crossref","first-page":"W162","DOI":"10.2214\/AJR.15.14365","article-title":"Levoatriocardinal Vein and Mimics: Spectrum of Imaging Findings","volume":"205","author":"Agarwal","year":"2015","journal-title":"AJR Am J Roentgenol"},{"key":"2026032606351840000_19.3.e271489.4","doi-asserted-by":"crossref","first-page":"314","DOI":"10.2214\/AJR.17.19128","article-title":"Evaluation of Unroofed Coronary Sinus Syndrome Using Cardiovascular CT Angiography: An Observational Study","volume":"211","author":"Sun","year":"2018","journal-title":"AJR Am J Roentgenol"},{"key":"2026032606351840000_19.3.e271489.5","doi-asserted-by":"crossref","first-page":"23","DOI":"10.4274\/tjod.galenos.2019.02679","article-title":"Prenatal diagnosis of persistent left superior vena cava: a retrospective study of associated congenital anomalies","volume":"16","author":"\u00d6zs\u00fcrmeli","year":"2019","journal-title":"Turk J Obstet Gynecol"},{"key":"2026032606351840000_19.3.e271489.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12872-025-04922-2","article-title":"Postpartum ischemic stroke due to persistent left superior vena cava to left atrium after DORV repair: a case report and literature review","volume":"25","author":"C\u00e1rdenas-Mar\u00edn","year":"2025","journal-title":"BMC Cardiovasc Disord"},{"key":"2026032606351840000_19.3.e271489.7","doi-asserted-by":"crossref","first-page":"130","DOI":"10.5090\/kjtcs.2018.51.2.130","article-title":"Management of Coronary Sinus Ostial Atresia during a Staged Operation of a Functional Single Ventricle","volume":"51","author":"Kang","year":"2018","journal-title":"Korean J Thorac Cardiovasc Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-271489","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:35:30Z","timestamp":1774532130000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-271489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,26]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bcr-2025-271489"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-271489","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}