Interventional Partial Cavopulmonary Connection: Initial Clinical Experience With Acute Procedural up to Midterm Results.

Background: Creation of a partial cavopulmonary anasthomosis in patients with isolated right-sided heart failure or patients with cyanosis and intracardial right-to-left shunt and reduced blood flow in the pulmonary circulation may provide a significant improvement in exercise capacity and also facilitate the performance of activities of daily living in patients with a deteriorated clinical condition. However, surgical partial cavopulmonary connection creation may be a high-risk procedure in this patient group. An interventional partial cavopulmonary connection may provide a less invasive treatment modality for these patients. The aim of the study was a retrospective evaluation of patients who underwent the creation of an interventional partial cavopulmonary connection.

Methods: Each patient who was qualified for treatment underwent a preinterventional computed tomography scan with 3-dimensional reconstruction for improved procedure planning. As a preparation preceding the interventional partial cavopulmonary connection, a prestent (bare metal stent) was implanted into the superior vena cava during cardiac catheterization in most cases. The perforation was performed with the use of needle punctures as a straightforward method in all cases. Thereafter, a covered stent was implanted, connecting the superior vena cava and the right pulmonary artery.

Results: Between July 2019 and July 2024, 14 patients (male n=6, 43%) underwent an interventional partial cavopulmonary connection. The indication for treatment was deteriorated clinical condition (n=12, 86%) or significant cyanosis (n=2, 14%). The procedure was performed successfully in all cases. The median follow-up time was 19.8 months (minimum 2.7; maximum 65.6).

Conclusions: Our study shows that transcatheter creation of partial cavopulmonary connection provides a promising treatment modality for selected adult patients with right-sided heart failure and may lead to clinical improvement in this patient group.