Transcatheter Correction of Superior Sinus Venosus Atrial Septal Defect: A Case Series

Background: Transcatheter correction of superior sinus venosus atrial septal defect (SVASD) with partial anomalous pulmonary venous drainage (PAPVD) of the right upper and/or right middle pulmonary vein (RUPV/RMPV) has recently been described as an alternative to surgical approach in a substantial number of patients. In this case series, we describe the procedural technical details and evaluate the feasibility, safety, and procedural success of transcatheter correction of SVASD with PAPVD in three consecutive patients.

Method: From 2019 to 2021, three consecutive patients received a transcatheter correction of SVASD with PAPVD by redirecting RUPV/RMPV to the left atrium and closure of this SVASD by implantation of a custom-made premounted covered Cheatham platinum stent. Prior to stent implantation, a ballon interrogation using an Amplatzer sizing ballon was performed in the anticipated landing zone with simultaneous transesophageal echocardiography and selective right pulmonary venous angiography to confirm complete defect closure and unobstructed pulmonary venous drainage. After stent deployment, the inferior stent portion was flared with a Z med II ballon to reduce residual shunt and prevent stent embolization.

Results: Transcatheter correction of SVASD with PAPVD was performed in all three patients without any peri- or postprocedural complications and with no residual shunt in two and a trivial residual shunt in one patient. The medium follow-up period was 11.7 months with no mortality, stent embolization, or obstruction of pulmonary venous drainage.

Conclusion: Transcatheter correction of SVASD with PAPVD is safe and feasible with excellent postproducedural results and represents an alternative to surgical treatment in a preselected patient cohort.

Publication History

Article published online:
12 February 2022