Transhepatic device closure of atrial septal defect in children associated with interrupted inferior vena cava

Area of Science:

• Interventional Cardiology
• Congenital Heart Disease
• Vascular Access

Background:

• Percutaneous transcatheter closure is a standard treatment for fossa ovalis atrial septal defects (FOASD).
• Alternative access routes are necessary when the typical femoral venous approach is contraindicated, such as in cases of interrupted inferior vena cava (IVC) or occluded femoral veins.
• Transjugular, transhepatic, or surgical methods are potential alternatives for FOASD closure.

Purpose of the Study:

• To describe the successful application of a transhepatic approach for device closure of FOASD in patients with interrupted IVC.
• To present a case series demonstrating the feasibility and safety of this alternative technique.

Main Methods:

• Device closure of FOASD using a transhepatic venous access.
• Utilized percutaneous techniques for catheter and device delivery.
• Managed patients with interrupted inferior vena cava (IVC).

Main Results:

• Successful device closure of FOASD was achieved in two patients with interrupted IVC.
• The transhepatic approach was performed without any complications.
• Demonstrated the efficacy of the transhepatic route for FOASD closure in challenging anatomies.

Conclusions:

• Transhepatic device closure of FOASD is a safe and effective alternative when the transjugular or femoral venous approach is not feasible.
• This technique expands interventional options for patients with complex venous anatomy and FOASD.
• Highlights the adaptability of transcatheter techniques in congenital heart defect management.