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.