Transcatheter occlusion of sinus venosus atrial septal defect – a new therapeutic option?

Chamié, Francisco; Peralta, Daniel; Torres, Rômulo Francisco de Almeida; Tress, João Carlos; Lacoste, Maximiliano Otero

doi:10.31160/jotci202028a20200007

Cited by 3 publications

(7 citation statements)

References 14 publications

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“…Covered stent implantation in sinus venosus defects has been described extensively. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] An adequate length of stent is expanded to grip the nonstenotic distensible SVC without displacement, and extends inferiorly to cover the defect with additional expansion to seal the lower end of the defect in the upper RA. The anomalous right upper pulmonary veins now drain behind the covered stent to the LA.…”

Section: Stent Implantationmentioning

confidence: 99%

“…The earlier reports in the literature invariably used several telescoping stents to correct the defect, adapting the available stent technology used more frequently in treating aortic coarctation and pulmonary arteries. 1,2,4,5,[7][8][9][10] Whilst these were suitable for many of the cases, it became clear that larger diameter and longer stents were likely to be more effective. This was clearly demonstrated using 3D printed models of the hearta step likely to be taken by most new centers undertaking these procedures.…”

Section: Stent Lengthmentioning

confidence: 99%

“…The first stent implant reports in 2013 and 2014 were followed by sporadic case reports and small series using different stents and implantation techniques. [1][2][3][4][5][6][7][8][9][10][11][12] As with many new procedures that develop and evolve using existing technology, the equipment may not be of an ideal design and technical compromises may need to be made. More recently a few larger series of more than 20 patients have been reported with encouraging results so that covered stent correction is now becoming an acceptable alternative to surgical repair in carefully selected cases.…”

Section: Introductionmentioning

confidence: 99%

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Correction of sinus venosus atrial septal defects with the 10 zig covered Cheatham‐platinum stent – An international registry

Rosenthal

Qureshi

Jones

et al. 2021

Cathet Cardio Intervent

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Background Covered stent correction of sinus venosus ASDs (SVASD) is a relatively new technique. Challenges include anchoring a sufficiently long stent in a nonstenotic superior vena cava (SVC) and expanding the stent at the wider SVC‐RA junction without obstructing the anomalous right upper pulmonary vein (RUPV). The 10‐zig covered Cheatham‐platinum (CCP) stent has the advantage of being available in lengths of 5–11 cm and dilatable to 34 mm in diameter. Methods An international registry reviewed the outcomes of 10‐zig CCP stents in 75 patients aged 11.4–75.9 years (median 45.4) from March 2016. Additional stents were used to anchor the stent in the SVC or close residual shunts in 33/75. An additional stent was placed in 4/5 (80%) with 5/5.5 cm CCPs, 18/29 (62%) with 6 cm CCPs, 5/18 (28%) with 7 cm CCPs, 5/22 (23%) with 7.5/8 cm CCPs and 0/1 with an 11 cm CCP. A “protective” balloon catheter was inflated in the RUPV in 17. Results Early stent embolization in two patients required surgical removal and defect repair and tamponade was drained in one patient. The CT at 3 months showed occlusion of the RUPV in one patient. Follow up is from 2 months to 5.1 years (median 1.8 years). QP:QS has reduced from 2.5 ± 0.5 to 1.2 ± 0.36 (p < .001) and RVEDVi from 149.1 ± 35.4 to 95.6 ± 21.43 ml/m2 (p < .001). Conclusions Ten‐zig CCPs of 7–8 cm appear to provide reliable SVASD closure with a low requirement for additional stents. Careful selection of patients and meticulous attention to detail is required to avoid complications.

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Section: Stent Implantationmentioning

confidence: 99%

Section: Stent Lengthmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Correction of sinus venosus atrial septal defects with the 10 zig covered Cheatham‐platinum stent – An international registry

Rosenthal

Qureshi

Jones

et al. 2021

Cathet Cardio Intervent

View full text Add to dashboard Cite

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“…Over the last 6 years, transcatheter closure has emerged as an alternative to open heart surgery with more institutions reporting their experience. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Different operators used different techniques to implant a covered stent in the superior vena cava (SVC) to close the SVASD and to redirect flow of the anomalous vein back to the left atrium (LA). Since the initial report in Frankfurt at CSI meeting (by Hussein Abdullah, MD and colleagues) and the series from Evelina Children's hospital in London (Hansen), 1 strategies have evolved to minimize stent instability and embolization as well as to minimize residual shunting.…”

Section: Introductionmentioning

confidence: 99%

“…Until recently, sinus venosus atrial septal defects (SVASD) were exclusively surgically corrected. Over the last 6 years, transcatheter closure has emerged as an alternative to open heart surgery with more institutions reporting their experience 1–15 . Different operators used different techniques to implant a covered stent in the superior vena cava (SVC) to close the SVASD and to redirect flow of the anomalous vein back to the left atrium (LA).…”

Section: Introductionmentioning

confidence: 99%

Novel technique for transcatheter closure of sinus venosus atrial septal defect: The temporary suture‐holding technique

Hejazi

Hijazi

Saloos

et al. 2022

Cathet Cardio Intervent

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Background: Transcatheter repair of sinus venosus atrial septal defect (SVASD) has become an alternative option to surgical repair. There are potential significant complications related to stent stability in the superior vena cava (SVC) and potential migration of the stent that need to be addressed. Therefore, the technique is still evolving.Objectives: To report results of a new modification "the suture technique" that improves safety profile of positioning and securing a covered stent in the SVC.Methods: This is a descriptive, single center, retrospective review of patients who underwent SVASD closure using the suture technique at our institution between 02/2020 and 08/2022.Results: Fourteen patients underwent transcatheter repair of SVASD using the suture technique. All procedures were successful. The suture technique allowed precise stent placement in all patients without any migration or complication. Six patients required additional stent placement at the level of the SVC. One patient had an additional covered stent placed to eliminate a tiny residual shunt. Two patients had negligible residual shunts at the time of the procedure. At follow-up, all patients clinically improved and had significant reduction in right heart size on echocardiography and/or magnetic resonance imaging. No arrhythmia was reported in any patient. None required re-intervention after a mean follow-up of 16.5 ± SD 10.5 months. Conclusions:The suture technique appears to be safe modification. Although our study involves small sample size with no comparative group, we believe our technique offers greater control over stent positioning, reducing the risk of stent embolization and residual shunting in transcatheter closure of SVASD.

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Percutaneous occlusion of sinus venosus atrial septal defect using a covered stent: the importance of imaging methods for printing three-dimensional models and better clinical decision-making

Teixerense,

Pacheco,

Lacoste

et al. 2023

J Transcat Intervent

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A superior sinus venosus atrial septal defect is usually accompanied by an anomalous venous connection to a right superior or middle pulmonary vein or veins, draining directly into the superior vena cava or even into the cavoatrial junction. This is a case report of a 62-year-old female patient, diagnosed with a sinus venosus atrial septal defect, with overload of the right chambers, for whom a percutaneous occlusion procedure was planned, using a previous cardiovascular tomography and, sequentially, a three-dimensional anatomical study, with the publicly available software 3D Slicer. In addition, a resin model was printed for inspection and simulation of a stent implantation. The patient was treated percutaneously with a 60-mm covered Chetham-Platinum stent, with total occlusion of the defect, absence of residual shunts, and draining flow from the right superior pulmonary vein to the left atrium, through a posterior communication between the atria, a sine qua non prerequisite to perform this type of procedure. Planning of the percutaneous occlusion procedure of the sinus venosus atrial septal defect involves careful evaluation of imaging tests. The printing of virtual or physical models, derived from computed tomography angiography of the heart, is essential for a detailed study of the defect and associated anatomical structures, minimizing the occurrence of complications.

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Transcatheter occlusion of sinus venosus atrial septal defect – a new therapeutic option?

Abstract: Transcatheter occlusion of sinus venosus atrial septal defecta new therapeutic option?Oclusão transcateter de comunicação interatrial do tipo seio venoso -uma nova opção terapêutica?

Cited by 3 publications

References 14 publications

Correction of sinus venosus atrial septal defects with the 10 zig covered Cheatham‐platinum stent – An international registry

Correction of sinus venosus atrial septal defects with the 10 zig covered Cheatham‐platinum stent – An international registry

Novel technique for transcatheter closure of sinus venosus atrial septal defect: The temporary suture‐holding technique

Percutaneous occlusion of sinus venosus atrial septal defect using a covered stent: the importance of imaging methods for printing three-dimensional models and better clinical decision-making

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