J Am Coll Cardiol Intv. Oct 18, 2023. Epublished DOI: 10.1016/j.jcin.2023.07.024
Superior sinus venosus defect is a communication between the right and left atrium located above the upper margin of the oval fossa, immediately inferior to the junction of the superior vena cava and the right atrium. It is systematically associated with partial anomalous pulmonary venous drainage, especially of the right upper pulmonary vein. Surgical repair has been the gold standard approach to close that defect. Introduced in 2014, percutaneous closure has gradually become a safe and effective alternative to surgery in carefully selected patients, although worldwide experience remains limited. This article provides an appraisal of the patients’ selection process and a step-by-step description of the procedure as well as a comprehensive review of its outcomes.
• Surgical repair is the standard of care for superior sinus venosus defect with partial anomalous pulmonary venous drainage. However, transcatheter closure is emerging as a safe and effective alternative in carefully selected patients.
• Knowledge of the anatomy of crossroads formed by the right upper pulmonary vein, superior vena cava, right atrium, and left atrium is key to appreciating the procedural concept.
• Optimal patient selection requires the integration of multimodality imaging, 3D modeling, and balloon interrogation of the superior vena cava.
• Modified techniques along with growing experience of interventionalists will further enhance safety and expand the role of transcatheter closure of SVD.