A technique of handling severe coronary sinus rupture when direct suture repair or pericardial patch techniques have failed is described. A pericardial patch is sewn over the coronary sinus with running 5-0 Prolene suture, and an 8-mm thin-walled Gore-Tex conduit then is constructed between the patch and the right atrium to decompress the repair and allow an alternative route for coronary sinus return to the right atrium.