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.