A case of atrial septal defect associated with anomalous sinoatrial node
artery in pulmonary atresia with intact ventricular septum
Abstract
An 11-year-old boy affected by pulmonary atresia with intact ventricular
septum (AP-IVS) was listed for percutaneous pulmonary valvuloplasty and
closure of multi-fenestrated atrial septal defect (ASD). Intraprocedural
transesophageal echocardiography arose the suspect of abnormal coronary
artery pattern while selective angiography documented a single
sinoatrial node artery (SANa) with an unusual retro-aortic course. As
consequence, we proceeded to effectively close the defects with a not
self-centering device placed in the most central side hole. This case
supports the hypothesis that sometimes arrhythmic complication during
ASD closure procedures might be due to unrecognized injury of the SANa.