PMC9479748_01
Coronary angiography revealed aneurysmal left circumflex artery with no significant disease in the left anterior descending or right coronary artery.
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F1
The left anterior descending and right coronary artery both had minimal disease (Figure 1).
(A) Three-chamber view on transthoracic echocardiogram shows the cystic structure with no contrast flow after normal saline injection. (B) Four-chamber view on transesophageal echocardiogram showing the cystic structure in relation to the left atrium. (C) Tethered posterior leaflet.
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F2
An unusual cystic structure was visualized posterior and lateral to the left atrium (Figure 2 A). The study suggested features of an unroofed coronary sinus atrial septal defect but was not conclusive due to significant clot burden (Figures 2 B, C; Video 1).
Transesophageal echocardiogram with color Doppler showing severe mitral regurgitation. see also at https://youtu.be/CDsc0Bmqym0
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V1
A large thrombosed coronary sinus and aneurysmal left circumflex were visualized (Figure 3).