Transcatheter versus surgical treatment for isolated superior sinus venosus atrial septal defect |
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| Authors: | Federica Brancato MD Natasha Stephenson MD Eric Rosenthal MD Jan H Hansen MD Matthew I Jones MD Shakeel Qureshi MD Conal Austin MD Simone Speggiorin MD Salih Caner MD Gianfranco Butera MD PhD |
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| Institution: | 1. Department of Congenital Cardiology, Evelina London Children's Hospital, Guy's & St Thomas' 2. NHS Foundation Trust, London, UK;3. NHS Foundation Trust, London, UK
Department of Congenital Heart Disease and Paediatric Cardiology, University Hospital Schleswig-Holstein, Kiel, Germany |
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| Abstract: | Background The superior sinus venosus atrial septal defect is a congenital communication between the left and right atria. Open surgical approach by patch closure has historically been the only treatment option. Recently, a transcatheter approach has been developed. This study aims to compare the efficacy and safety of surgical and transcatheter approach in treatment of sinus venosus atrial septal defect. Methods Between March 2010 and December 2020, 58 patients (median age: 45.4, range 14.8?73.8) underwent either surgical or transcatheter correction of superior sinus venosus atrial septal defect with partial anomalous pulmonary venous drainage. Results Twenty-four patients (median age: 35.4, range 14.8?66.8) underwent surgery while 34 patients (median age: 46.8, range 15.5?73.8) had a transcatheter treatment. During the catheterization era, 41 patients was considered suitable for a transcatheter closure. In 5 patients, surgery was the patient's or referring physician's choice. In 2 cases, the procedure was unsuccessful; the remaining 34 were successfully closed (94.4% of cases). Intensive care unit stay (median of 1 day, range 0.5?4, vs. 0, range 0?2, p < 0.0001) and hospital stay (median 7 days, range 2?15 vs. 2 days, range 1?12, p < 0.0001), were significantly longer in the surgery group. Total early complication rate, consisted on procedural and in-hospital complication, were higher in the surgical group (62.5% vs. 23.5%; p = 0.005). However, complications in both groups were clinically mild. At follow-up, a small residual shunt was present in 6 patients (surgery group: 2 pts; catheterization group: 4 pts; p: NS). Imaging studies showed significant improvement of right ventricular size and unobstructed pulmonary venous return in all patients. No late complications occurred at follow-up. Conclusions Transcatheter correction of sinus venosus atrial septal defect is effective and safe in selected patients and may be considered as a valid alternative to surgery. |
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| Keywords: | atrial septal defects cardiac surgery catheterization congenital |
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