Journal of cardiovascular computed tomography · 2025
New anatomical classification to plan transcatheter correction of sinus venosus defect based on 3D models.
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Batteux Clément, Gkogkou Efthymia, Albenque Grégoire, Andarelli Jean Noel, Ciobotaru Vlad, Roussin Régine, Hascoet Sébastien
Аннотация
BACKGROUND: Superior sinus venosus defect (SVD) is a complex congenital heart disease (CHD) with a wide spectrum of anatomical variants. The innovative transcatheter correction of SVD (TCSVD) is feasible in selected cases. Patient selection requires a detailed anatomical evaluation. This study aims to provide an anatomical classification of SVD using 3D models.
METHODS: Computed tomography (CT) scans of hearts with superior SVD were 3D-modeled using semi-automatic segmentation. Key parameters such as superior vena cava (SVC) size, SVC overriding, caudal defect extension, and size/orientation of the anomalous pulmonary vein (APV) were assessed in this single-center cohort study.
RESULTS: We included 197 patients with superior SVD. SVC overriding was absent in 38 % of cases and exceeded 50 % in 7 % of cases. A single APV ostium was identified in 52 % of patients and additional ostia in 48 % of patients. Among children older than 12 years, 83 % had an SVC diameter greater than 14 mm (at the first quartile in adults). Based on the amount of SVC overriding and caudal extension of the defect, we classified the SVDs into two types: fenestration (30 %) and cavo-atrial (70 %). Associated lesions included left superior vena cava (15 %) and ostium secundum atrial septal defect (8 %).
CONCLUSION: A standardized 3D evaluation of SVDs provided a new anatomical classification that should prove useful for tailoring TCSVD strategies.
METHODS: Computed tomography (CT) scans of hearts with superior SVD were 3D-modeled using semi-automatic segmentation. Key parameters such as superior vena cava (SVC) size, SVC overriding, caudal defect extension, and size/orientation of the anomalous pulmonary vein (APV) were assessed in this single-center cohort study.
RESULTS: We included 197 patients with superior SVD. SVC overriding was absent in 38 % of cases and exceeded 50 % in 7 % of cases. A single APV ostium was identified in 52 % of patients and additional ostia in 48 % of patients. Among children older than 12 years, 83 % had an SVC diameter greater than 14 mm (at the first quartile in adults). Based on the amount of SVC overriding and caudal extension of the defect, we classified the SVDs into two types: fenestration (30 %) and cavo-atrial (70 %). Associated lesions included left superior vena cava (15 %) and ostium secundum atrial septal defect (8 %).
CONCLUSION: A standardized 3D evaluation of SVDs provided a new anatomical classification that should prove useful for tailoring TCSVD strategies.
Предметные рубрики MeSH
HumansFemaleMaleChildVena Cava, SuperiorImaging, Three-DimensionalCardiac CatheterizationAdolescentPredictive Value of TestsAdultChild, PreschoolHeart Septal Defects, AtrialComputed Tomography AngiographyYoung AdultRadiographic Image Interpretation, Computer-AssistedInfantPulmonary VeinsPhlebographyPatient-Specific ModelingRetrospective StudiesTreatment OutcomeMiddle Aged