Long-Term Postoperative Outcomes of Sinus Venosus Defect.

Background/Objectives: Despite advances in transcatheter therapy, surgery remains the gold standard treatment for sinus venosus defect (SVD). However, data on long-term outcomes following surgical repair remain scarce. This multicenter study evaluates the long-term outcomes of surgically treated SVD patients with comparison to surgically and percutaneously treated secundum atrial septal defect (ASD). Methods: Clinical, surgical, imaging and invasive data were retrospectively reviewed from eight centers in Europe. Results: A total of 209 patients were included, of whom 80 were surgically treated SVD, 57 surgically treated secundum ASD and 72 percutaneously treated secundum ASD. Operation for SVD mainly occurred in adulthood, with a median age of 28.5 years (2-68 years). During follow-up, the observed reoperation rate was higher in the SVD cohort than ASD cohorts (p = 0.033), despite shorter follow-up period in the SVD cohort. Reoperations, in the SVD cohort, occurred at a median of 28 years (1-50 years) after index surgery. The need for pacemaker implantation was similar between groups (p = 0.301). The prevalence of late atrial fibrillation did not differ between groups (p = 0.588). Surgically treated SVD tended to have a higher prevalence of atrial flutter and atrial tachycardia, with a significantly higher rate of electrophysiological studies than percutaneously treated secundum ASD (p = 0.013), similar to surgically treated secundum ASD (p = 0.405). Conclusions: Long-term follow-up of surgically treated SVD is essential to monitor for reintervention and arrhythmic complications.