-Case Reports-

Surgical Treatment of a Defect Recurring 22 Years after Closure of an Inferior Sinus Venosus Defect: A Case Report

Kenji Suzuki¹, Takashi Sasaki¹, Keisuke Ohta¹, Junya Aoyama¹, Shun-Ichiro Sakamoto¹, Yoshiyuki Watanabe¹, Makoto Watanabe², Ryuji Fukazawa² and Yosuke Ishii¹

¹Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan
²Department of Pediatrics, Nippon Medical School, Tokyo, Japan

Background: Residual shunt after closure of an inferior sinus venosus defect (ISVD) is a rare complication with a high rate of reintervention.
Case Presentation: Here, we report a rare case of a recurrent defect identified 22 years after closure of an ISVD. The defect (25 × 10 mm) was located at the inferior vena cava-right atrial junction and was closed directly when the patient was 5 years of age. No residual shunt was detected and follow-up was discontinued at age 12 years. However, a residual atrial septal defect shunt was detected incidentally at age 27 years. During the second surgery, the lower end of the original defect was opened and then closed with an expanded polytetrafluoroethylene patch.
Conclusions: Because of the high rate of reintervention for residual shunt after ISVD closure, patch closure was selected as a better option to reduce tension at the inferior-posterior border. Patients with this profile should be followed closely, at least during childhood, including by echocardiography.

J Nippon Med Sch 2023; 90: 272-275

Keywords
adult congenital heart disease, atrial septal defect, inferior sinus venosus defect, reoperation

Correspondence to
Kenji Suzuki, MD, Department of Cardiovascular Surgery, Nippon Medical School Musashi Kosugi Hospital, 1-383 Kosugimachi, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
suzuki@nms.ac.jp

Received, August 24, 2021
Accepted, November 22, 2021