We present the 2-dimensional findings and 3-dimensional reconstruction of i
mages from an 18-year-old patient with unroofed coronary sinus, persistent
left superior vena cava, a common atrium with levoisomerism, ventricular se
ptal defect, and double-outlet right ventricle. The left superior vena cava
showed continuity with the floor of the coronary sinus. Diagnosis of the c
onstellation of anomalies established by transesophageal reconstruction cla
rified the continuity of the coronary sinus with left superior vena cava an
d atrial wall.