# Simultaneous Identification of Unroofed Coronary Sinus Atrial Septal Defect and Atrial Septal Defect Secundum Using Cardiac Computed Tomography Angiography

## TL;DR

A rare case of two heart defects, ASD secundum and unroofed coronary sinus, was diagnosed and successfully treated in a young woman using advanced imaging techniques.

## Contribution

This case report highlights the simultaneous identification of two rare atrial septal defects using cardiac computed tomography angiography.

## Key findings

- ASD secundum was initially diagnosed using TTE and confirmed with TEE.
- CCTA identified an incidentally found UCS type II.
- The patient successfully underwent a reroofing procedure with a bovine pericardial patch.

## Abstract

Unroofed coronary sinus (UCS) represents a rare subtype of atrial septal defect (ASD), an adult congenital heart disease characterized by communication between the systemic and pulmonary circulations at the atrial level. This case report presents the unique occurrence of a large, unrepaired ASD secundum and an incidentally identified UCS type II in a 25-year-old female during a cardiac murmur assessment. The diagnosis of ASD secundum was initially made using transthoracic echocardiography (TTE) and was later confirmed with a transesophageal echocardiogram. The identification of the UCS was achieved through the utilization of cardiac computed tomography angiography (CCTA). Ultimately, the patient underwent a successful reroofing procedure using a bovine pericardial patch.