Transcatheter Repair of Sinus Venosus Defect Using a 12-zig Covered Cheatham-Platinum Stent in Large Superior Vena...

Sinus venosus defect (SVD) is a rare congenital heart anomaly characterised by an abnormal communication between the atria, often associated with partial anomalous pulmonary venous connection (PAPVC). Traditional surgical repair carries significant risks, prompting exploration into less invasive transcatheter approaches. This study aims to evaluate the efficacy and safety of a 12-zig covered Cheatham-platinum stent for the correction of SVD, particularly in patients with enlarged superior vena caval-right atrial (SVC-RA) junctions unsuitable for standard stenting techniques. A retrospective analysis was conducted on five symptomatic patients treated with the 12-zig CP stent across two institutions. Preprocedural imaging, including echocardiograms, cardiac MRIs, and CT angiograms was performed to assess right ventricular function and define anatomical relationships. The procedures were guided by transoesophageal echocardiography (TOE) and involved balloon sizing to ensure optimal stent placement. All five patients (80% male, median age 59 years) successfully underwent stent implantation. A second stent was required in three cases due to residual leaks, which were effectively sealed, and in one case for stent stability. No procedural complications were reported, and all patients experienced symptomatic improvement at follow-up, with imaging confirming stable stent positions. The 12-zig CP stent demonstrates feasibility in the percutaneous treatment of highly selected patients with SVD, allowing for effective closure in complex anatomies, including large SVC-RA junctions. This study underscores the potential of advanced imaging techniques and tailored interventions in enhancing patient outcomes with complex congenital heart disease previously unsuitable for standard transcatheter approaches.