SPC365

Comparison of transcatheter and surgical repair of superior sinus venosus atrial septal defect: insights from a tertiary center

Session: Sessão de Posters 33 - Cardiopatia congénita e hipertensão pulmonar: da evidência à ação
Speaker: Francisco Barbas De Albuquerque

Congress: CPC 2026
Topic: F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme: 20. Congenital Heart Disease and Pediatric Cardiology
Subtheme: 20.4 Congenital Heart Disease – Treatment
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Francisco Barbas de Albuquerque; Konstantinos Dimopoulos; Andreas Hoschtitzky; Wei Li; Michael A Gatzoulis; Alexander Kempny

<p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Background</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Surgical repair (SR) has been the standard treatment for superior sinus venosus atrial septal defect (SVASD), but transcatheter repair (TR) has recently emerged as a less invasive alternative. This study compared TR and SR outcomes regarding procedural success, outcomes, and right ventricular (RV) remodeling and function.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Methods</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Single-center retrospective study of adults (&ge;18 years) who underwent repair of SVASD.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Results</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Ninety patients were included (TR=21, SR=69; median age 57 vs. 47 years, <em>p</em>=0.011). In the SR group, the technique most used was single-patch repair (n=40) and concomitant tricuspid annuloplasty was performed in six patients. In SR group, the covered AndraTec Optimus XXL stent was used in majority of cases (n=15) and pulmonary vein protection was performed 62% of cases. Both groups showed significant RV reverse remodeling by echocardiography and cardiac MRI. Post-repair, tricuspid annular plane systolic discursion (TAPSE) remained normal in 91.3% after TR, compared to just 8.3% in SR group, <em>p</em>&lt;0.001, Figure 1A. &nbsp;There was also significant reduction of RV free-wall strain after SR, but not TR,&nbsp;Figure 1B. Procedural success was 100% in both groups. Residual shunt was more frequent after TR (28.5% vs. 1.4%, <em>p</em>&lt;0.001), although it was mild in majority of patients (n=5, 83%) and significant in 1 (17%) patient only. Both groups had a significant improvement in WHO functional class after repair (Figure 1C). Hospital stay was shorter after TR group (1 [1-2] vs 7 [6-9] days, <em>p</em>&lt;0.001).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">SR group had a longer follow-up time, as compared to TR group (78 [9-142] vs 20 [4-37] months, <em>p</em>=0.001). </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">During follow-up, in the TR group, one patient had surgery due to residual shunt, two patients had re-intervention with stent post-dilation and one had pacemaker implantation; in the SR group, two patients had pacemaker implantation, two had SVC obstruction managed conservatively and one had IVC obstruction requiring balloon dilation. No pulmonary vein obstruction was observed in either group.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Conclusion</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">This study demonstrates safety of TR for SVASD, with both TR and SR promoting RV remodeling. Following TR, RV function remained stable, whilst it significantly declined after SR. TR offered shorter hospitalization but was associated with a higher incidence of residual shunting, albeit mild in majority of patients.</span></span></span></span></p>