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El-Andari R, Moolla M, John K, Slingerland A, Campbell S, Nagendran J, Hong Y, Mathew A. Outcomes Following Surgical Repair of Sinus Venosus Atrial Septal Defects: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2024:e033686. [PMID: 38874063 DOI: 10.1161/jaha.123.033686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/15/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Sinus venosus atrial septal defect (SVASD) is a rare congenital cardiac anomaly comprising 5% to 10% of all atrial septal defects. Although surgical closure is the standard treatment for SVASD, data on outcomes have been confined to small cohorts. Thus, we conducted a systematic review of the outcomes of SVASD repair. METHODS AND RESULTS The primary outcome was death. Secondary outcomes encompassed atrial fibrillation, sinus node dysfunction, pacemaker insertion, cerebrovascular accident, reoperation, residual septal defect, superior vena cava obstruction, and reimplanted pulmonary vein obstruction. Pooled incidences of outcomes were calculated using a random-effects model. Forty studies involving 1320 patients who underwent SVASD repair were included. The majority were male patients (55.4%), with 88.0% presenting with associated anomalous pulmonary venous connection. The weighted mean age was 18.6±12.5 years, and the overall weighted mean follow-up period was 8.6±10.4 years. The in-hospital mortality rate was 0.24%, with a 30-day mortality rate of 0.5% reported in 780 patients. Incidences of atrial fibrillation, sinus node dysfunction, pacemaker insertion, and cerebrovascular accident over the long-term follow-up were 3.3% (2.18%-4.93%), 6.5% (5.09%-8.2%), 2.23% (1.34%-3.57%), and 2.03% (0.89%-2.46%) respectively. Reoperation occurred in 1.36% (0.68%-2.42%) of surgeries, residual septal defect in 1.34% (0.69%-2.42%), superior vena cava obstruction in 1.76% (1.02%-2.9%), and reimplanted pulmonary vein obstruction in 1.4% (0.7%-2.49%). CONCLUSIONS This is the first comprehensive analysis of outcomes following surgical repair of SVASD. The findings affirm the safety and effectiveness of surgery, establishing a reference point for evaluating emerging transcatheter therapies. Safety and efficacy profiles comparable to surgical repair are essential for widespread adoption of transcatheter treatments.
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Affiliation(s)
- Ryaan El-Andari
- Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta Heart Institute University of Alberta Edmonton Alberta Canada
| | - Muhammad Moolla
- Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute University of Alberta Edmonton Alberta Canada
| | - Kevin John
- Division of Internal Medicine, Department of Medicine Tufts University Medford MA USA
| | - Ashley Slingerland
- Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada
| | | | - Jeevan Nagendran
- Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta Heart Institute University of Alberta Edmonton Alberta Canada
| | - Yongzhe Hong
- Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta Heart Institute University of Alberta Edmonton Alberta Canada
| | - Anoop Mathew
- Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute University of Alberta Edmonton Alberta Canada
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Kaemmerer H, Diller GP, Achenbach S, Dähnert I, Eichstaedt CA, Eicken A, Freiberger A, Freilinger S, Geiger R, Gorenflo M, Grünig E, Hager A, Huntgeburth M, Kaemmerer-Suleiman AS, Kozlik-Feldmann R, Lammers AE, Nagdyman N, Michel S, Schmidt KH, Uebing A, von Scheidt F, Apitz C. [Pulmonary hypertension in adults with congenital heart disease in light of the 2022-ESC-PAH guidelines - Part II: Supportive therapy, special situations (pregnancy, contraception, non-cardiac surgery), targeted pharmacotherapy, organ transplantation, special management (shunt lesions, left ventricular disorders, univentricular hearts), interventions, intensive care, follow-up, future perspectives]. Pneumologie 2024. [PMID: 38788761 DOI: 10.1055/a-2274-1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
The number of adults with congenital heart defects (CHD) is steadily rising and amounts to approximately 360,000 in Germany. CHD is often associated with pulmonary hypertension (PH), which may develop early in untreated CHD. Despite timely treatment of CHD, PH not infrequently persists or recurs in older age and is associated with significant morbidity and mortality.The revised European Society of Cardiology/European Respiratory Society 2022 guidelines for the diagnosis and treatment of PH represent a significant contribution to the optimized care of those affected. However, the topic of "adults with congenital heart disease" is addressed only relatively superficial in these guidelines. Therefore, in the present article, this topic is commented in detail from the perspective of congenital cardiology.
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Affiliation(s)
- Harald Kaemmerer
- Internationales Zentrum für Erwachsene mit angeborenen Herzfehlern (EMAH), Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Deutschland
| | - Gerhard Paul Diller
- Klinik für Kardiologie III: angeborene Herzfehler (EMAH) und Klappenerkrankungen, Universitätsklinikum Münster, Münster, Deutschland
| | - Stephan Achenbach
- Universitätsklinik Erlangen, Medizinische Klinik 2 - Kardiologie und Angiologie, Erlangen, Deutschland
| | - Ingo Dähnert
- Universitätsklinik für Kinderkardiologie, Herzzentrum Leipzig, Leipzig, Deutschland
| | - Christina A Eichstaedt
- Zentrum für Pulmonale Hypertonie, Thoraxklinik Heidelberg am Universitätsklinikum Heidelberg, Heidelberg, Deutschland; Institut für Humangenetik, Universität Heidelberg, INF 366, TLRC am DZL Heidelberg, Deutschland
| | - Andreas Eicken
- Internationales Zentrum für Erwachsene mit angeborenen Herzfehlern (EMAH), Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Deutschland
| | - Annika Freiberger
- Internationales Zentrum für Erwachsene mit angeborenen Herzfehlern (EMAH), Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Deutschland
| | - Sebastian Freilinger
- Internationales Zentrum für Erwachsene mit angeborenen Herzfehlern (EMAH), Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Deutschland
| | - Ralf Geiger
- Univ.-Klinik für Pädiatrie III, Kardiologie, Pneumologie, Allergologie, Cystische Fibrose, Innsbruck, Österreich
| | - Matthias Gorenflo
- Klinik für Kinderkardiologie und angeborene Herzfehler, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Ekkehard Grünig
- Zentrum für Pulmonale Hypertonie, Thoraxklinik Heidelberg am Universitätsklinikum Heidelberg, Heidelberg, Deutschland; Institut für Humangenetik, Universität Heidelberg, INF 366, TLRC am DZL Heidelberg, Deutschland
| | - Alfred Hager
- Internationales Zentrum für Erwachsene mit angeborenen Herzfehlern (EMAH), Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Deutschland
| | - Michael Huntgeburth
- Internationales Zentrum für Erwachsene mit angeborenen Herzfehlern (EMAH), Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Deutschland
| | | | - Rainer Kozlik-Feldmann
- Klinik und Poliklinik für Kinderkardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Klinik und Poliklinik für Kinderherzmedizin und Erwachsene mit angeborenen Herzfehlern, Hamburg, Deutschland
| | - Astrid E Lammers
- Klinik für Pädiatrische Kardiologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Münster, Deutschland
| | - Nicole Nagdyman
- Internationales Zentrum für Erwachsene mit angeborenen Herzfehlern (EMAH), Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Deutschland
| | - Sebastian Michel
- LMU Klinikum, Herzchirurgische Klinik und Poliklinik, Sektion für Chirurgie angeborener Herzfehler und Kinderherzchirurgie, Campus Großhadern, München, Deutschland
| | - Kai Helge Schmidt
- Universitätsmedizin Mainz, Zentrum für Kardiologie - Kardiologie I, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Anselm Uebing
- Universitätsklinikum Schleswig-Holstein, Klinik für angeborene Herzfehler und Kinderkardiologie, Kiel, Deutschland
| | - Fabian von Scheidt
- Internationales Zentrum für Erwachsene mit angeborenen Herzfehlern (EMAH), Klinik für angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Deutschland
| | - Christian Apitz
- Sektion Pädiatrische Kardiologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Ulm, Deutschland
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Hascoët S, Roussin R, Batteux C. Treatment of sinus venosus defect: Time to tune. Int J Cardiol 2024; 399:131630. [PMID: 38048883 DOI: 10.1016/j.ijcard.2023.131630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Sebastien Hascoët
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine, Université Paris-Saclay, BME laboratory, 133 avenue de la résistance, 92350 Le Plessis Robinson, France; Inserm UMR-S 999, Marie Lannelongue hospital, Paris-Saclay university, 92350 Le Plessis Robinson, France.
| | - Régine Roussin
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine, Université Paris-Saclay, BME laboratory, 133 avenue de la résistance, 92350 Le Plessis Robinson, France
| | - Clément Batteux
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine, Université Paris-Saclay, BME laboratory, 133 avenue de la résistance, 92350 Le Plessis Robinson, France; Inserm UMR-S 999, Marie Lannelongue hospital, Paris-Saclay university, 92350 Le Plessis Robinson, France
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Baruteau AE, Hascoet S, Malekzadeh-Milani S, Batteux C, Karsenty C, Ciobotaru V, Thambo JB, Fraisse A, Boudjemline Y, Jalal Z. Transcatheter Closure of Superior Sinus Venosus Defects. JACC Cardiovasc Interv 2023; 16:2587-2599. [PMID: 37855807 DOI: 10.1016/j.jcin.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 10/20/2023]
Abstract
Superior sinus venosus defect is a communication between the right and left atrium located above the upper margin of the oval fossa, immediately inferior to the junction of the superior vena cava and the right atrium. It is systematically associated with partial anomalous pulmonary venous drainage, especially of the right upper pulmonary vein. Surgical repair has been the gold standard approach to close that defect. Introduced in 2014, percutaneous closure has gradually become a safe and effective alternative to surgery in carefully selected patients, although worldwide experience remains limited. This article provides an appraisal of the patients' selection process and a step-by-step description of the procedure as well as a comprehensive review of its outcomes.
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Affiliation(s)
- Alban-Elouen Baruteau
- Nantes Université, Centre Hospitalier Universitaire Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Nantes, France; Nantes Université, Centre Hospitalier Universitaire Nantes, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Scientifique, l'institut du thorax, Nantes, France; Nantes Université, Centre Hospitalier Universitaire Nantes, Institut National de la Santé et de la Recherche Scientifique, Centre d'Investigations Cliniques Femmes-Enfants-Adolescents 1413, Nantes, France; Nantes Université, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Unité Mixte de Recherche 1280, Physiologie des Adaptations Nutritionnelles, Nantes, France.
| | - Sébastien Hascoet
- Malformations Cardiaques Congénitales Complexes-Hôpital Marie Lannelongue, Department of Pediatric Cardiology and Congenital Heart Disease, Groupe Hospitalier Paris Saint Joseph, BME Lab, Institut National de la Santé et de la Recherche Scientifique UMR-S 999, Université Parsis Saclay, Le Plessis Robinson, France
| | - Sophie Malekzadeh-Milani
- Malformations Cardiaques Congénitales Complexes-Necker, Department of Congenital and Pediatric Cardiology, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - Clément Batteux
- Malformations Cardiaques Congénitales Complexes-Hôpital Marie Lannelongue, Department of Pediatric Cardiology and Congenital Heart Disease, Groupe Hospitalier Paris Saint Joseph, BME Lab, Institut National de la Santé et de la Recherche Scientifique UMR-S 999, Université Parsis Saclay, Le Plessis Robinson, France
| | - Clément Karsenty
- Department of Pediatrics, Centre Hospitalier Universitaire Toulouse, Université de Toulouse, Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, Toulouse, France
| | - Vlad Ciobotaru
- Malformations Cardiaques Congénitales Complexes-Hôpital Marie Lannelongue, Department of Pediatric Cardiology and Congenital Heart Disease, Groupe Hospitalier Paris Saint Joseph, BME Lab, Institut National de la Santé et de la Recherche Scientifique UMR-S 999, Université Parsis Saclay, Le Plessis Robinson, France; Clinique des Franciscaines, 3Dheartmodeling, Nîmes, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Adult Congenital Cardiology, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France; Electrophysiology and Heart Modeling Institute, Institut Hospital-Universitaire Liryc, Fondation Bordeaux Université, Bordeaux, France
| | - Alain Fraisse
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Younes Boudjemline
- Sidra Heart Center, Sidra Medicine, Weil Cornell Medical College, Doha, Qatar
| | - Zakaria Jalal
- Department of Pediatric and Adult Congenital Cardiology, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France; Electrophysiology and Heart Modeling Institute, Institut Hospital-Universitaire Liryc, Fondation Bordeaux Université, Bordeaux, France
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