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Ann Thorac Surg 2006;81:1275-1278
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Management of Central Coronary Sinus Ruptures Using the Pericardial Patch Repair Technique

Clemens Aigner, MD, Ernst Wolner, MD, Werner Mohl, MD, PhD *

Department of Cardio-Thoracic Surgery, Medical University of Vienna, Vienna, Austria

Accepted for publication November 22, 2005.

* Address correspondence to Dr Mohl, Department of Cardiothoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria (Email: werner.mohl{at}meduniwien.ac.at).

BACKGROUND: Intraoperative coronary sinus rupture is a rare event; however, it carries potential mortality and its' management is technically challenging. A repair technique should provide adequate bleeding control while avoiding narrowing or stricture of the coronary sinus.

METHODS: We retrospectively review our experience with a new pericardial patch repair technique. From January 1996 to May 2005 four cases of intraoperative coronary sinus injury were identified. Three female patients and one male patient with a mean age of 74 ± 4 years underwent valve replacement and/or coronary artery bypass on cardiopulmonary bypass. A double pericardial patch technique sandwiched with human fibrin glue was used to cover the defect.

RESULTS: In all patients treated with this method, the injury could be treated successfully. All patients were extubated on the first postoperative day and median intensive care unit stay was 3 days. Drains could be removed after 4 days median. Median hospital stay was 13 days. After a median follow-up of 33 months all patients are alive without any echocardiographic signs of impairments of the coronary sinus.

CONCLUSIONS: We conclude that the pericardial patch technique is a safe and technically feasible technique for repair of central coronary sinus ruptures. Excellent bleeding control and, in our experience, no consecutive complications were observed.




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