探讨无顶冠状静脉窦综合征(unroofed coronary sinus syndrome , UCSS)的临床特点及诊断方法，总结胸腔镜手术治疗UCSS的经验。

分析2010～2017年在西京医院心外科行全胸腔镜UCSS心内矫治术87例患者资料：Ⅰ型22例、Ⅱ型6例、Ⅲ型23例、Ⅳ型36例，其中对合并永存左上腔静脉(persistent left superior vena care，PLSVC)的22例Ⅰ型UCSS患者分别采用胸腔镜心内隧道法(20例)和房间隔重建法(2例)进行矫治。

经心脏彩超胸UCSS漏诊率4.5%，术后早期无死亡病例，手术成功率100%。术中主动脉阻断时间48～89 min，平均(65.2 ±19.3)min；体外循环时间70～131 min，平均(97.9±26.8)min；术后呼吸机辅助时间4～41 h，平均(10.2±5.3)h；ICU监护时间1～7 d，平均(2.5±1.6)d；术后住院时间5～14 d，平均(6.2±1.1)d。术后随访82例，失访5例；畸形矫治效果理想，无严重并发症，无再次手术患者。

经胸心脏彩超诊断UCSS存在一定的局限，建议心脏疾病患者术前食管超声的推广、普及。胸腔镜UCSS心内矫正术的技术成熟、手术安全有效、并发症少，同时胸腔镜手术在微创、美容、加速康复等方面优势突出，值得在临床大力推广。

To explore the clinical characteristics and diagnostic methods of unroofed coronary sinus syndrome(UCSS), and to summarize the experience of thoracoscopic surgery.

From 2010 to 2017, 87 cases of UCSS were performed in the cardiac surgery department of Xijing Hospital. The results showed that 22 cases were type Ⅰ, 6 cases were type Ⅱ, 23 cases were type Ⅲ and 36 cases were type Ⅳ. 22 cases of type Ⅰ UCSS with PLSVC were treated with thoracoscopic intracardiac tunnel (20 cases) and atrial septal reconstruction (2 cases).

The missed diagnosis rate of UCSS was 4.5%, There was no death in the early postoperative period, and the success rate was 100%. The rest were cured and discharged. The duration of aortic occlusion during operation was 48-89(65.2 ±19.3)min; the duration of cardiopulmonary bypass was 70-131(97.9±26.8)min; the duration of ventilator assistance after operation was 4-41(10.2±5.3)h; the duration of ICU monitoring was 1-7 (2.5±1.6) d; and the length of hospital stay was 5-14(6.2±1.1)d. 82 cases were followed up and 5 cases were lost. The effect of deformity correction was ideal. There were no serious complications and no reoperation patients.

There are some limitations in the diagnosis of UCSS by transthoracic echocardiography. It is suggested that preoperative esophageal echocardiography be popularized in cardiac surgery. The technique of UCSS is successful, safe and effective, with fewer complications. At the same time, thoracoscopic surgery has prominent advantages in minimally invasive, cosmetic and rapid rehabilitation, which is worthy of vigorous promotion.