International Experience of Transcatheter Sinus Venosus Defect Closure in Children and Adolescents.

Transcatheter closure of sinus venosus defects (SVD) is an emerging alternative to surgery, however, concerns remain regarding growth potential in paediatric patients treated with fixed-diameter stents. This retrospective study included individuals younger than 18 years from 12 centres. SVD closure was performed using covered stents after demonstration of right upper pulmonary vein redirection during balloon interrogation. Complete closure without significant residual flow was defined as procedural success. Major complications were those necessitating surgical intervention, whereas minor complications were managed intraprocedurally. Among 54 patients < 18 years, 17 had bilateral superior vena cava and six had a high-draining vein. The majority (37) underwent single-stent placement; others required multiple stents. Procedural success was 98.1%, with one embolization needing surgery. Seven needed extra stents due to migration or instability. Minor complications included arrhythmia and stent thrombus. Compared to global registry data, this cohort required smaller sheaths and fewer stents. Pulmonary vein protection and jugular-railroad techniques were frequently employed; transseptal puncture was less frequent. Over a follow-up period ranging 1-174 months, three cases of residual shunt necessitated reintervention. No late stent thrombosis was noted. One deep vein thrombosis and two instances of mild asymptomatic pulmonary vein gradients were managed conservatively. Transcatheter closure of SVD is both feasible and safe in paediatric populations. Smaller anatomical structures permitted use of single-stents through smaller sheaths, thereby streamlining the intervention. Continued long-term surveillance will be essential to further elucidate benefits in young patients. Future advancements in stent-technology and increased procedural expertise are expected to enhance outcomes.