Transcatheter Correction of Superior Sinus Venosus Atrial Septal Defects as an Alternative to Surgical Treatment

Transcatheter occlusion of sinus venosus atrial septal defect – a new therapeutic option?

“…Hansen reported the largest case-series, in which 83% out of 48 patients were successfully treated. 9,21 In this small case-series, the age of patients stands out, all over the third decade of life, which is unusual in ASDs series. Those were cases that escaped detection at TTEs, in which this diagnosis is rather tricky, demanding an experienced specialist on congenital heart defects.…”

“…Unfortunately larger and longer stents, utilized by others, were not available at the time of the procedures. 21 Possible complications of the procedure are similar to surgery, mainly sinus node lesion and RUPV stenosis.…”

“…Nowadays, other authors have opted for this type of SVASD correction. 9,21,22 There is no way to determine by TEE, in advance, which patient will or will not be suitable for the procedure. The only way to determine suitability is by performing simultaneous RUPV angiography with SVC balloon occlusion.…”

New Insights into Sinus Venosus Defects from Cross-Sectional Imaging

“…Both MRI and CT angiograms can be used for 3D modeling and printing for feasibility of catheter-based closure of the defect or surgical guidance and simulation (Fig. 16) [49][50][51][52][53]. In patients with superior sinus venosus defect, a single autologous pericardial patch/baffle can be sufficient to restore the pulmonary venous return to the left atrium without narrowing of the superior vena caval drainage (single patch technique).…”

Non-invasive Imaging in the Evaluation of Cardiac Shunts for Interventional Closure

“…Sinus venosus ASD is characterized by deficiency of the common wall between the superior vena cava (SVC) and the right upper pulmonary vein (RUPV), which is no longer committed to the left atrium. It constitutes up to 11% of all cases with ASD (43) and is used to be limited to surgical repair which can now be considered for catheter intervention with good results (44). The procedure involves implantation of a covered stent which replaces the deficient posterior wall of the SVC, thereby closing the SVASD and redirecting the anomalous pulmonary veins into the LA behind the stent.…”