Original Article

Closure of Sinus Venous Atrial Septal Defects with Transcatheter Balloon Expanding Stent: A Case Series from Single Center Experience

Abstract

Background: A sinus venous atrial septal defect (SVASD) is a type of congenital heart defect that predominantly involves an opening between the Superior Vena Cava (SVC) and the Right Upper Pulmonary Vein (RUPV). Surgical closure of SVASD has been the standard treatment; however, the surgical closure of SVASD is far more complex than mere ASD secundum reconstruction, and complications are more likely. Transcatheter closure of SVASD is an emerging alternative for surgical repair.

Methods: We report five cases of successful transcatheter closure of SVASD and one case of failure that required surgical intervention. All patients underwent pre-procedure Computed Tomography Angiography (CTA) to determine the size and location of the defect and the optimal stent size and position. The SVC stenting was performed using balloon-expandable stents, followed by RUPV angioplasty if needed.

Results:  Final angiograms and pressure measurements in the SVC, RUPV, and Right Atrium (RA) confirmed the absence of residual shunt and pulmonary venous obstruction. One patient experienced stent migration to the pulmonary artery, which necessitated surgical retrieval and defect closure.

Conclusion: The balloon expansion test is not mandatory before stent implantation, as in the case of RUPV obstruction, its flow could be reestablished by ballooning and/or stent implantation within the RUPV with a mild residual shunt which might resolve spontaneously.

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Keywords
Sinus Venous Atrial Septal Defect SVASD Case Series Partial Anomalous Pulmonary Vein Transcatheter closure
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1.
Mortezaeian H, MozafaryBazargany M, Salmanipour A, Banazade Dardashty A. Closure of Sinus Venous Atrial Septal Defects with Transcatheter Balloon Expanding Stent: A Case Series from Single Center Experience. J Tehran Heart Cent. 2024;.