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. In nonsurgical candidates or those who prefer a percutaneous approach, there are 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 3 cases, with improvement in symptoms and in hemodynamic status. A total of 2 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 is a rare congenital condition, which is traditionally treated surgically. Adult patients with congenital heart disease are potentially nonsurgical candidates and, as such, benefit from percutaneous approaches. Our study describes the safety and feasibility of percutaneous closure of partial anomalous pulmonary venous return and the positive impact on hemodynamic and chamber measures.