Percutaneous Transcatheter Approach to Partial Anomalous Pulmonary Venous Return: A Case Series.

Abstract

Our study presents cases demonstrating the technique and safety of percutaneous occlusion of adult patients with partial anomalous pulmonary venous return (PAPVR). PAPVR is a rare condition that is traditionally treated surgically. Percutaneous interventions are rarely reported. Most patients with PAPVR present in youth and are surgical candidates. Among non-surgical candidates or those who prefer a percutaneous approach there is little available data to guide therapy. Patients with PAPVR and indications for intervention were treated with percutaneous techniques to occlude anomalous venous return and relieve the hemodynamic effects of these anomalies. Several different percutaneous techniques were used, sometimes in tandem to achieve occlusion. Percutaneous closure was achieved successfully in three cases with improvement in symptoms as well as improvement in hemodynamic status. Two patients achieved positive remodeling in right chamber sizes. In conclusion, Percutaneous occlusion of PAPVR is feasible with a multitude of transcatheter options available. This represents a novel approach to the adult patient with PAPVR, specifically those without a surgical option. Condensed Abstract: Partial anomalous pulmonary venous return (PAPVR) is a rare congenital condition which is traditionally treated surgically. Adult patients with congenital heart disease are potentially non-surgical candidates and as such benefit from percutaneous approaches. Our study describes the safety and feasibility of percutaneous closure of PAPVR as well as the positive impact on hemodynamic and chamber measures.