Transcatheter closure of inferior sinus venosus defect using a patent ductus arteriosus occluder following simulation with a 3D-printed model

Figure 1. It has shown the procedure for transcatheter closure (A-D), post-operative TTE (E,F), and the MSCT before discharge (G,H). One of the most important indications is that the waist must be appressed to ensure success. A push–pull test should be performed under fluoroscopy to ensure stability (A,B). If necessary, pulmonary angiography should be performed to verify whether the RPV return has been affected (C). Release of the occluder (D). Post-operative TTE shows the stability of the PDA occluder and an absence of residual shunting (E,F). MSCT shows obstruction of blood recirculation (G,H). TTE, transthoracic echocardiography; MSCT, multi-slice computed tomography; RPV, right pulmonary vein; PDA, patent ductus arteriosus.

Figure 2. (A-D) The 3DP simulation for the ASD occluder, while (E-H) show that for the PDA occluder. (A,B) Show the position of the occluder from the front view. (B,F) Show complete obstruction of RPV return using the ASD occluder yet slight obstruction using the PDA occluder. (C,G) Show that obstruction of IVC return was less substantial for the PDA occluder than for the ASD occluder. (D,H) Show the position and shape of each occluder under fluoroscopy when implanted in the 3DP model. LAA, left atrial appendage; LA, left atrium; IVC, inferior vena cava; ASD, atrial septal defect; RLPV, right lower pulmonary vein; RSPV, right superior pulmonary vein; RA, right atrium; RAA, right atrial appendage; PDA, patent ductus arteriosus; SVC, superior vena cava; CS, coronary sinus.

Figure 3. Preoperative (A,B) and postoperative (C,D) MSCT images. (C,D) Show no obstruction of the IVC or RPV. MSCT, multi-slice computed tomography; IVC, inferior vena cava; RPV, right pulmonary vein.

Figure 4. Position and shape of the device post-operation. No IVC (A, front view) or RPV (B, rear view) obstruction were observed following implantation of the PDA occluder. SVC, superior vena cava; RA, right atrium; LA, left atrium; LAA, left atrial appendage; IVC, inferior vena cava; CS, coronary sinus; PDA, patent ductus arteriosus; LLPV, left lower pulmonary vein; LSPV, left superior pulmonary vein; RLPV, right lower pulmonary vein; RSPV, right superior pulmonary vein.

Figure 5. ISVD exhibits a semicircular shape from an RA view (A), concave disc shape from a front view (B), and a relatively regular circular shape from an LA view (C). SVC, superior vena cava; LAA, left atrial appendage; IVC, inferior vena cava; EV, eustachian valve; ISVD, inferior sinus venosus defect; RA, right atrium; RAA, right atrial appendage; CS, coronary sinus; LA, left atrium; RLPV, right lower pulmonary vein.

Figure 6. A patient with both ISVD and ASD. The ISVD was closed using PDA occluder (A), following which the ASD occluder was implanted to close the secundum defect. The atrial septum and left disc skirt were clamped between the left and right discs (B,C), and the two defects were closed simultaneously (D). ISVD, inferior sinus venosus defect; ASD, atrial septal defect; PDA, patent ductus arteriosus.