Single center experience with covered stent closure of sinus venosus atrial septal defect.
To evaluate the feasibility, safety, and short-term outcomes of transcatheter closure of sinus venosus atrial septal defect (SVASD) using covered stents. We conducted an institutional retrospective analysis of 24 consecutive patients aged 15-70 years with superior SVASD and significant left-to-right shunting (QP/QS ≥ 1.5), who underwent percutaneous closure using covered stents between June 2021 and December 2023. Pre-procedural imaging included transesophageal echocardiography and cardiac Computed Tomography angiography (CTA). Procedural details, technical success, and echocardiographic parameters were recorded. Post-procedural outcomes were assessed with transthoracic echocardiography and/or CTA. The Patients' median age was 38 years (IQR: 28-53), and 50% were female. Median Atrial Septal Defect (ASD) size was 15 mm (IQR: 11-19), and median QP/QS ratio decreased from 1.8 (IQR: 1.7-1.95) to 1.1 (IQR: 1.0-1.25) after closure (p < 0.001). Covered stents were used in all cases, and 13 patients (54.1%) required additional non-covered stent support. Technical success was achieved in 96% of patients, with one case of device embolization requiring surgical intervention. Minor complications occurred in 7 patients (29.1%), including hematoma and asymptomatic thrombosis. No mortality was observed. At 3 months, right ventricular dysfunction and enlargement significantly improved (p = 0.004 and p = 0.001, respectively), while right atrial size remained unchanged (p = 0.317). Catheter-based repair of SVASD is feasible, safe, and effective with a low rate of complications. This approach may offer a minimally invasive alternative to surgery in anatomically suitable patients.
Authors
Firuzi Firuzi, Khajali Khajali, Saedi Saedi, Baay Baay, Elahifar Elahifar, Talis Talis, Pouraliakbar Pouraliakbar, Bakhshande Bakhshande, Kiasaraee Kiasaraee, Gholipour Gholipour, Khalilipur Khalilipur
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