Closure of Sinus Venosus Atrial Septal Defects with Transcatheter Balloon-Expandable Stents: A Single-Center Case
Hojjat Mortezaeian1, Mohammad Hossein Mozafary Bazargany1, Ali Reza Salmanipour1
1Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Background:
Sinus venosus atrial septal defect (SVASD) is a congenital heart defect involving an opening between the superior vena cava (SVC) and the right upper pulmonary vein (RUPV). Surgical closure is the standard treatment. Nonetheless, it is more complex than secundum ASD reconstruction and is associated with higher complication rates. Transcatheter closure is an emerging alternative.
Methods:
We report 5 cases of transcatheter SVASD closure and 1 case of failure requiring surgical intervention. All patients underwent preprocedural computed tomography angiography to assess defect size and location and optimal stent dimensions. SVC stenting was performed using balloon-expandable stents, followed by RUPV angioplasty if necessary.
Results:
Final angiograms and pressure measurements in the SVC, RUPV, and right atrium confirmed the absence of residual shunt and pulmonary venous obstruction. Stent migration to the pulmonary artery occurred in 1 patient, necessitating surgical retrieval and defect closure.
Conclusions:
Balloon expansion testing is not mandatory before stent implantation. If RUPV obstruction occurs, flow can be reestablished via ballooning or stent implantation within the RUPV, and associated mild residual shunts may resolve spontaneously.
