Covered stent correction of sinus venous atrial septal defect (SVASD), an alternative to surgical repair, comes with the challenges of anchoring a stent of sufficient length in a distensible and non-stenotic superior vena cava (SVC) and expanding the stent to diameters up to 1.5-3.0 times the SVC at the SVC-right atrial junction. A covered CP (CCP) stent available in lengths of 5-11 cm and dilatable to 34 mm in diameter with moderate shortening has been FDA approved at lengths of 5-6 cm, with longer stents requiring more research. Investigators reviewed outcomes data from 75 patients aged 11-75 who received various lengths of the stent. In 32 participants, additional stents were used to anchor the stent in the SVC or to close residual shunts. All cases with SVC landing zone stents required a third stent for stability. In 80% of cases with 5.0-5.5-cm CCPs, an additional stent was placed, compared with 62% of those with 6.0-cm CCPs, 28% with 7.0-cm CCPs, 23% with 7.5-8.0-cm CCPs, and 0% of those with 11.0-cm CCPs.

Author