Modified safety techniques for transcatheter repair of superior sinus venosus defects with partial anomalous pulmonary venous drainage using a 100-mm Optimus-CVS® covered XXL stent

We report the first use of a single 100-mm long custom-made version of the Optimus-CVS® balloon-expandable PTFE-covered XXL (15-Zig) stent (AndraTec, GmbH) to eliminate sinus venosus defect left-to-right shunt and redirect anomalous right pulmonary veins blood flow through a new walled channel to the left atrium. Anatomical feasibility and strategy decision were guided by ex-vivo procedure simulation on the patient-specific 3D printed heart model and in-vivo balloon interrogation. Modified procedural and implantation techniques are detailed. Immediate and one-month follow-up showed excellent outcomes.

Surgical Approaches to Total Anomalous Pulmonary Venous Connection

Total anomalous pulmonary venous connection (TAPVC) constitutes a spectrum of congenital lesions whereby the pulmonary veins remain connected to systemic venous vessels or aberrantly connect to the right atrium. Definitive management requires surgical intervention and, in patients with obstruction to pulmonary venous flow, urgent operation is required. Use of temporizing catheter-based interventions allow for optimization in hemodynamically unstable neonates. Overall, survival has significantly improved over the past decades through better perioperative management and evolution of surgical approaches to minimize post-repair pulmonary vein stenosis, which persists as a major determinant of long-term outcomes.