Correction of Sinus Venosus Atrial Septal defects with the 10 zig covered CP Stent–an International Registry - 14/08/21
, Shakeel A. Qureshi, MD FSCAI a, Matthew Jones a : MBBS, Gianfranco Butera, MD, PhD a, b, Kothandam Sivakumar, MD DM c, Younes Boudjemline, MD PhD d, Ziyad M. Hijazi, MD MSCAI d, Salim Almaskary, MD e, Reid D. Ponder, MD f, Morris M. Salem, MD FSCAI f, Kevin Walsh, MD g, Damien Kenny, MD FSCAI g, Sébastien Hascoet, MD h, Clément Batteux, MD h, Darren P. Berman, MD FSCAI i, John Thomson, MD FSCAI j, Joseph J. Vettukattil, MBBS k, Evan M. Zahn, MD MSCA l
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Résumé |
Covered stent correction of sinus venosus ASDs (SVASD) is a relatively new technique. Challenges include anchoring a sufficiently long stent in a non-stenotic SVC and expanding the stent at the wider SVC-RA junction without obstructing the anomalous right upper pulmonary vein (RUPV). The 10-zig covered CP (CCP) stent has the advantage of being available in lengths of 5–11cm and dilatable to 34mm in diameter.
Methods |
An international registry reviewed the outcomes of 10-zig CCP stents in 75 patients aged 11.4–75.9 years (median 45.4) from March 2016. Additional stents were used to anchor the stent in the SVC or close residual shunts in 33/75. An additional stent was placed in 4/5 (80%) with 5/5.5cm CCPs, 18/29 (62%) with 6cm CCPs, 5/18 (28%) with 7cm CCPs, 5/22 (23%) with 7.5/8cm CCPs and 0/1 with an 11cm CCP. A “protective” balloon catheter was inflated in the RUPV in 17.
Results |
Early stent embolisation in two patients required surgical removal and defect repair and tamponade was drained in one patient. The CT at 3 months showed occlusion of the RUPV in one patient. Follow up is from 2 months to 5.1 years (median 1.8 years). QP:QS has reduced from 2.5+0.5 to 1.2+0.36 (P<0.001) and RVEDVi from 149.1+35.4 to 95.6+21.43ml/m2 (P<0.001).
Conclusions |
10-zig CCPs of 7–8cm appear to provider reliable SVASD closure with a low requirement for additional stents. Careful selection of patients and meticulous attention to detail is required to avoid complications.
Le texte complet de cet article est disponible en PDF.Keywords : Sinus Venosus ASD, Covered Stent, Congenital Heart Disease, Interventional Catheterisation
Plan
Vol 13 - N° 4
P. 279 - septembre 2021 Retour au numéro
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