Abstract 1254 Decision Support for Transcatheter Intervention in Sinus Venous Defects with Partial Anomalous Pulmonary Venous Drainage – Patient-specific Viability Assessment using In-Silico and In-Vitro Models

Superior sinus venosus atrial septal defects (SVASD) are associated with partial anomalous pulmonary venous drainage (PAPVD) and lead to significant left-to-right shunting and, thus, right ventricular volume overload. Clinically, heart failure and rhythm disturbances can occur if the lesion is left untreated.

Transcatheter treatment of SVASD is based on implantation of a covered stent reaching from the superior vena cava into the right atrium with subsequent balloon shaping of the stent and flow of the pulmonary venous flow around this stent. However, the method is novel and, therefore, treatment planning is essential in order to ensure adequate device selection according to the patient-specific anatomy. We aimed to describe an approach to non-invasive treatment planning in common cases of SVASD/PAPVD prior to the actual procedure in the catheter lab.

Firstly, a 3D geometrical model can be generated based on computed tomography (CT) imaging. Subsequently, in-silico virtual stent sizing can be performed according to the hydraulic diameter of the anticipated “landing zone” and the estimated stent shortening. With this approach, (1) eligible patients for transcatheter treatment and (2) suitable devices can be selected before invasive catheterization is performed. Furthermore, 3D printed models allow for in-vitro testing of different device options. We also demonstrate how computer-based visualization and overlay techniques before and during treatment may further help to guide interventionists through the procedure and to reduce the risks of residual shunt or pulmonary vein obstruction in patients who are suitable for transcatheter treatment.

Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
Decision Support for Transcatheter Intervention in Sinus Venous Defects with Partial Anomalous Pulmonary Venous Drainage – Patient-specific Viability Assessment using In-Silico and In-Vitro Models
A. Schleiger¹, M. Kelm¹, J. Nordmeyer¹, P. Kramer¹, L. Goubergrits², T. Kühne², F. Berger¹, J. Brüning²
¹Klinik für angeborene Herzfehler/Kinderkardiologie, Deutsches Herzzentrum Berlin, Berlin; ²Charité - Universitätsmedizin Berlin, Berlin;
Superior sinus venosus atrial septal defects (SVASD) are associated with partial anomalous pulmonary venous drainage (PAPVD) and lead to significant left-to-right shunting and, thus, right ventricular volume overload. Clinically, heart failure and rhythm disturbances can occur if the lesion is left untreated. Transcatheter treatment of SVASD is based on implantation of a covered stent reaching from the superior vena cava into the right atrium with subsequent balloon shaping of the stent and flow of the pulmonary venous flow around this stent. However, the method is novel and, therefore, treatment planning is essential in order to ensure adequate device selection according to the patient-specific anatomy. We aimed to describe an approach to non-invasive treatment planning in common cases of SVASD/PAPVD prior to the actual procedure in the catheter lab. Firstly, a 3D geometrical model can be generated based on computed tomography (CT) imaging. Subsequently, in-silico virtual stent sizing can be performed according to the hydraulic diameter of the anticipated “landing zone” and the estimated stent shortening. With this approach, (1) eligible patients for transcatheter treatment and (2) suitable devices can be selected before invasive catheterization is performed. Furthermore, 3D printed models allow for in-vitro testing of different device options. We also demonstrate how computer-based visualization and overlay techniques before and during treatment may further help to guide interventionists through the procedure and to reduce the risks of residual shunt or pulmonary vein obstruction in patients who are suitable for transcatheter treatment.
https://dgk.org/kongress_programme/jt2022/aV317.html