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Updated: Jan 16, 2026
Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
New anatomical classification to plan transcatheter correction of sinus venosus defect based on 3D models
Clément Batteux1, Efthymia Gkogkou2, Grégoire Albenque1
1Filière des cardiopathies congénitales enfant adultes, hôpital Marie Lannelongue, centre constitutif du réseau maladies rares malformations cardiaques congénitales complexes - M3C, les Hôpitaux Saint Joseph et Marie Lannelongue, 133 avenue de la résistance, 92350, Le Plessis Robinson, France; Faculté de Médecine Kremlin-Bicêtre, Université Paris-Saclay, France; Université Paris-Saclay, INSERM, UMR_S 999, Hypertension Pulmonaire: Physiopathologie and Innovation Thérapeutique (HPPIT), AP-HP, Hôpital Bicêtre, Hôpital Marie Lannelongue (Groupe Hospitalier Paris Saint Joseph), ERN-LUNG, Le Plessis-Robinson, France.
Background:
Superior sinus venosus defect (SVD) is a complex congenital heart disease (CHD) with a wide spectrum of anatomical variants. The innovative transcatheter correction of SVD (TCSVD) is feasible in selected cases. Patient selection requires a detailed anatomical evaluation. This study aims to provide an anatomical classification of SVD using 3D models.
Methods:
Computed tomography (CT) scans of hearts with superior SVD were 3D-modeled using semi-automatic segmentation. Key parameters such as superior vena cava (SVC) size, SVC overriding, caudal defect extension, and size/orientation of the anomalous pulmonary vein (APV) were assessed in this single-center cohort study.
Results:
We included 197 patients with superior SVD. SVC overriding was absent in 38 % of cases and exceeded 50 % in 7 % of cases. A single APV ostium was identified in 52 % of patients and additional ostia in 48 % of patients. Among children older than 12 years, 83 % had an SVC diameter greater than 14 mm (at the first quartile in adults). Based on the amount of SVC overriding and caudal extension of the defect, we classified the SVDs into two types: fenestration (30 %) and cavo-atrial (70 %). Associated lesions included left superior vena cava (15 %) and ostium secundum atrial septal defect (8 %).
Conclusion:
A standardized 3D evaluation of SVDs provided a new anatomical classification that should prove useful for tailoring TCSVD strategies.
