Angiocardiographic feature of total anomalous venous return into coronary sinus simulating tricuspid atresia or stenosis

Four patients with total anomalous pulmonary venous return into coronary sinus showed angiocardiographic findings suggestive of tricuspid atresia or stenosis. All four infants had venous angiocardiograms performed through the superior vena cava. The contrast material entered the right atrium where it met the blood returned by the inferior vena cava and the blood from the lungs by way of the coronary sinus. Most of the contrast substance was directed toward the left side of the heart and consequently only a small amount of dyed blood passed into the right ventricle and the pulmonary artery. In all instances, a filling defect was seen at the level of the tricuspid valve. These findings are similar to those of tricuspid atresia.