Roopesh Bojja Venkata Satya, Sivakumar Kothandam, Sagar Pramod, Mullasari Ajit Sankardas
Department of Cardiology, Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, Tamil Nadu, India.
Ann Pediatr Cardiol. 2024 Nov-Dec;17(6):459-465. doi: 10.4103/apc.apc_194_24. Epub 2025 Apr 24.
Superior vena cava (SVC) type of sinus venosus defect (SVD) associated with anomalous right upper pulmonary vein (RUPV) drainage is often corrected by open-heart surgery. Transcatheter-covered stent exclusion is an attractive emerging alternative using a covered stent in the lower end of SVC to close the SVD and redirect the RUPV to the left atrium. The location of SVD posterosuperior to oval fossa challenges its transthoracic echocardiographic identification and delays its diagnosis to adult age. Lifestyle adult diseases, including atherosclerosis, elevate the left ventricular end-diastolic pressures and increase the pretricuspid left-to-right shunt. Surgery addresses coronary stenosis and SVD, but lifestyle diseases increase surgical risks. We diagnosed significant coronary stenosis in three patients with SVD. These patients underwent percutaneous management of both lesions. Nonsurgical management of SVD and ischemic heart disease is a more viable alternative than a high-risk surgery in adults with comorbidities.
与右上肺静脉（RUPV）异常引流相关的上腔静脉（SVC）型静脉窦缺损（SVD）通常通过心脏直视手术进行矫正。经导管覆膜支架封堵术是一种有吸引力的新兴替代方法，即在SVC下端使用覆膜支架关闭SVD并将RUPV重定向至左心房。SVD位于卵圆窝后上方的位置对经胸超声心动图识别造成挑战，并将其诊断推迟至成年期。包括动脉粥样硬化在内的成人生活方式疾病会升高左心室舒张末期压力并增加三尖瓣前左向右分流。手术可解决冠状动脉狭窄和SVD问题，但生活方式疾病会增加手术风险。我们诊断出3例SVD患者存在严重冠状动脉狭窄。这些患者对两种病变均进行了经皮治疗。对于患有合并症的成年人，SVD和缺血性心脏病的非手术治疗是比高风险手术更可行的替代方法。
