Ten years of percutaneous treatment of sinus venosus defects: evolution of an innovative procedure

Introduction: The superior sinus venosus defect is an uncommon CHD, typically associated with partial anomalous pulmonary venous drainage. While surgical correction is the traditional treatment, transcatheter techniques have emerged as a promising alternative. This analysis assesses the evolution of transcatheter correction for superior sinus venosus defect over the past decade, analysing trends on technique, procedural outcomes, and safety. Methods: Systematic research identified 23 studies involving approximately 676 patients from 2014 to 2024. Data on demographics, procedural details, and outcomes were extracted, and study quality was assessed using established checklists. Descriptive analyses and trend evaluations were conducted. Results: Initially, transcatheter procedures were reserved for high surgical-risk cases, but recent studies emphasise selecting patients with favourable anatomy for interventional closure. Improved screening and patient referral have reduced exclusion rates. While earlier studies utilised 3D printing for planning, later studies increasingly employed periinterventional imaging, particularly CT-fluoroscopy fusion. Balloon-expandable long covered stents, especially custom-made designs, became predominant, with median stent length increasing from 55 mm to 75 mm. Complication rates, including stent embolisation and pulmonary vein obstruction, declined over time. Conclusions: Advancements in patient selection, imaging modalities, and procedural techniques have improved the safety and efficacy of transcatheter superior sinus venosus defect correction, reducing reliance on surgical interventions. Custom stents and advanced imaging have played key roles in achieving better outcomes. However, larger studies are required to confirm these findings and evaluate long-term outcomes.