Transcatheter closure of inferior sinus venosus defect using a patent ductus arteriosus occluder following simulation with a 3D-printed model.

J Thorac Dis

Department of Structural Heart Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

Published: July 2022

AI Article Synopsis

  • This study investigates the feasibility of using transcatheter closure with patent ductus arteriosus (PDA) occluders to treat inferior sinus venosus defects (ISVD), which are typically considered contraindications for such methods.
  • Twelve patients with ISVD less than 25 mm underwent personalized 3D modeling and successful interventional therapy, where PDA and atrial septal defect (ASD) occluders were implanted simultaneously.
  • Follow-up results over an average of 48 months showed significant improvements in heart measurements and no major adverse events, suggesting that this approach could offer a promising new treatment for ISVD.

Article Abstract

Background: Transcatheter closure of inferior sinus venosus defect (ISVD) is still contraindication. To explore whether transcatheter closure with patent ductus arteriosus (PDA) occluders is possible for ISVD.

Methods: From June 2014 to March 2021, 12 patients were recruited diagnosed as <25 mm ISVD. The three-dimensional printing (3DP) heart model was produced based on multi-slice computed tomography (MSCT) scans. Preoperative closure simulation was planned on the personalized 3D model for each patient. Follow-up including electrocardiography (ECG), transthoracic echocardiography (TTE), and X-ray was traced.

Results: 3DP models of 12 patients were successfully printed. Twelve patients had been diagnosed with <25 mm ISVD and 4 of them had another secundum atrial septal defect (ASD). All patients were produced interventional therapy successfully. PDA occluder was implanted to closed ISVD, and ASD was closed using ASD occluder simultaneously. The average diameter of ISVD measured by TTE was (12.67±3.80), and the average diameter of sagittal axes and longitudinal axes measured by the 3D-printed model was (17.08±3.20) and (18.42±4.62) mm, respectively. The average size of PDA (diameter of pulmonary artery side) was (28.17±3.35) mm. Compared with the preoperative, the X-ray cardiothoracic ratio (0.51±0.04 0.47±0.06, P=0.007) and the right ventricle anterior-posterior diameter (31.17±5.65 24.58±3.75 mm, P<0.001) of postoperative was significantly decreased. During the average (47.75±27.52) months follow-up, it has achieved satisfying results, and there were no severe adverse events such as device transposition, death, and pericardial tamponade occurred.

Conclusions: Assisting by 3D heart model, transcatheter closure of ISVD with PDA occluder had an excellent outcome. This method provides a new considerable treatment strategy for ISVD.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344427PMC
http://dx.doi.org/10.21037/jtd-21-1782DOI Listing

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