Sinus venosus atrial septal defects (SVASDs) account for less than 10% of all atrial septal defects (ASDs). These defects are characterized by a lack of a wall separating the superior vena cava (SVC) from the right upper pulmonary vein, leading to a left-to-right shunt at a high atrial level (partial anomalous pulmonary venous drainage). Historically, all SVASDs required surgical treatment. Nonetheless, in the last decade, the SVC type of SVASD, which is amenable to device closure, can be closed via percutaneous angiography. SVC-type SVASDs result in a left-to-right shunt, progressively leading to right ventricular enlargement, tricuspid valve insufficiency, and pulmonary hypertension. Patients typically present with symptoms such as exertional dyspnea, palpitations, and atypical chest pain. Most commonly, SVASDs are associated with the SVC, where blood from the right upper and/or middle pulmonary veins drains into the SVC or the right atrium.
This report describes the successful transcatheter treatment of an SVC-type SVASD with pulmonary hypertension in a 59-year-old patient who presented with atypical chest pain and progressive dyspnea with moderate-to-severe activity. (Iranian Heart Journal 2025; 26(4): 89-97)