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Primary repair of coronary sinus injury caused by direct cutdown.

We report on a iatrogenic perioperative injury to the coronary sinus. Although oversewing venous bleeding sites on the heart usually resolves the problem, this caused an enormous venous engorgement of the posterior and apical regions of the heart, which prompted us to direct primary suture of the coronary sinus incision. A brief literature review with possible suggestions for solving this problem is given.