Sequential transcatheter closure of sinus venosus and secundum atrial septal defects using covered stents and a septal occluder, a two-step strategy: a case report

Superior sinus venosus atrial septal defect (SVASD) is an uncommon congenital anomaly frequently associated with partial anomalous pulmonary venous drainage (PAPVD). Surgical repair has traditionally been the standard treatment; however, transcatheter strategies have recently emerged as viable alternatives in selected patients.

We describe a 22-year-old Persian male with SVASD and PAPVD who underwent a staged transcatheter intervention. Initially, two PTFE-covered stents were deployed at the superior vena cava-right atrial junction to redirect pulmonary venous flow and exclude the defect. Due to residual shunting and persistent symptoms, a second procedure was performed, during which a septal occluder device was implanted to close the residual SVASD and a concomitant secundum ASD. The combined approach achieved effective defect closure and symptomatic improvement.

This case illustrates the feasibility of a minimally invasive, staged endovascular strategy for complex SVASD with PAPVD. In carefully selected patients, this approach may represent an alternative to surgery.