Unroofed Coronary Sinus in a Dog: Diagnostic Utility of ECG-Gated Computed Tomography

A Labrador Retriever (4-year-old, castrated male) with signs of fatigue was diagnosed with an atrial septal defect at his primary veterinary clinic. Due to the uncertainty of this diagnosis, he was referred to the Tokyo University of Agriculture and Technology Animal Medical Center for further investigation. Transthoracic echocardiography performed on arrival showed an irregular blood flow from the left atrium (LA) to the right atrium (RA), yet no opening was found in the septum. An electrocardiogram (ECG)-gated computed tomography (CT) exam revealed a communication between the coronary sinus (CS) and the LA, causing a shunt between the LA and the RA. A diagnosis of unroofed coronary sinus syndrome (UCSS) was made. The dog's condition was stable and plans to keep observations were made. This is the first case of UCSS diagnosed with an ECG-gated CT exam.