Publications

19 décembre 2024

Circulation. 2024 Dec 19. doi: 10.1161/CIRCULATIONAHA.124.070271. Online ahead of print.

Eric Rosenthal ¹ , Shakeel A Qureshi ¹ , Kothandam Sivakumar ² , Matthew Jones ¹ , San-Fui Yong ¹ , Saleha Kabir ¹ , Pramod Sagar ² , Puthiyedath Thejaswi ² , Sebastien Hascoet ³ , Clement Batteux ³ , Younes Boudjemline ⁴ , Ziyad M Hijazi ⁴ , Jamil A Aboulhosn ⁵ , Daniel S Levi ⁶ , Morris M Salem ⁶ , Edwin Francis ⁷ , Aleksander Kempny ⁸ , Alain Fraisse ⁸ , Carles Bautista-Rodriguez ⁸ , Kevin Walsh ⁹ , Damien Kenny ⁹ , Brian Traynor ⁹ , Salim N Al Maskari ¹⁰ , James R Bentham ¹¹ , László Környei ¹² , Muthukumaran C Sivaprakasam ¹³ , Ata Firouzi ¹⁴ , Zahra Khajali ¹⁴ , Lee Benson ¹⁵ , Mark Osten ¹⁵ , Alban-Elouen Baruteau ¹⁶ , Matthew A Crystal ¹⁷ , Thomas J Forbes ¹⁸ , Stanimir Georgiev ¹⁹ , Horst Sievert ²⁰ , Do Nguyen Tin ²¹ , Daniel Springmuller ²² , Anand Subramanian ²³ , Hussein A M Abdullah ²⁴ , Radwa Bedair ²⁵ , Francisco Chamié ²⁶ , Ahmet Celebi ²⁷ , Jesus Damsky Barbosa ²⁸ , Pieter De Meester ²⁹ , Luca Giugno ³⁰ , Zakaria Jalal ^{31 32 33} , Clement Karsenty ³⁴ , Anastasia Schleiger ³⁵ , Gregory Fleming ³⁶ , Andre Jakob ³⁷ , Tevfik Karagoaz ³⁸ , Gur Mainzer ³⁹ , Gareth J Morgan ⁴⁰ , Nazmi Narin ⁴¹ , Shabana Shahanavaz ⁴² , Zachary L Steinberg ⁴³ , Osamah Aldoss ⁴⁴ , Elnur Alizade ⁴⁵ , Oliver Aregullin ⁴⁶ , Hélène Bouvaist ⁴⁷ , Thilo Fleck ⁴⁸ , Francois Godart ⁴⁹ , Sophie Malekzadeh-Milani ⁵⁰ , Paulo Motta ⁵¹ , Angel Sanchez-Recalde ⁵² , Juan Pablo Sandoval ⁵³ , Weiyi Tan ⁵⁴ , John Thomson ⁵⁵ , Pablo Tome ⁵⁶ , Evan M Zahn ⁵⁷

PMID: 39697167 DOI: 10.1161/CIRCULATIONAHA.124.070271

Abstract

Background: Covered stent correction for a sinus venosus atrial septal defect (SVASD) was first performed in 2009. This innovative approach was initially viewed as experimental and was reserved for highly selected patients with unusual anatomic variants. In 2016, increasing numbers of procedures began to be performed, and in several centers, it is now offered as a standard of care option alongside surgical repair. However, covered stent correction for SVASD is not recognized by regulatory authorities, and in the minds of many pediatric and adult congenital cardiologists and surgeons, the condition is viewed as treatable only by cardiac surgery with cardiopulmonary bypass.

Methods: In April 2023, all centers identified from international conferences, publications, and colleague networks to be undertaking covered stent correction for SVASD were invited to participate in a retrospective audit of their procedures.

Results: Data were received on 381 patients from 54 units over a 12-year period with 90% of procedures being performed over the past 5 years. Balloon-expandable stents (8 types) were used in the majority; self-expanding stents (4 types) were used in 4.5%. The commonest stent was the 10-zig covered Cheatham Platinum stent in 62% of cases. In 10 procedures, the stent embolized requiring surgical retrieval and repair of the defect, resulting in technically successful implantation in 371 of 381 (97.4%). Major complications (surgical drainage of tamponade, pacemaker implantation, surgery for pulmonary vein occlusion, and late stent removal) occurred in 5 patients (1.3%). Repeat catheterization to correct residual leaks was required in 7 patients (1.8%). Thus, 359 of 381 patients (94.2%) had successful correction without major complications or additional catheter interventions.

Conclusions: This article details the exponential uptake of covered stent correction for SVASD during the past 5 years. Cardiopulmonary bypass was avoided in the majority of patients, and major complications were infrequent. Prospective registries with standardized definitions, inclusion criteria, and follow-up and comparative studies with surgery are now required to help support the extension of covered stent correction as an alternative standard-of-care option for patients with an SVASD.

Keywords: atrial septal defect; sinus venosus stents.

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