{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:59:11Z","timestamp":1790593151194,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A 40\u2010year\u2010old woman was referred for cardiac assessment following a syncopal event. Echocardiography showed a dilated right ventricle and subsequent cross\u2010sectional imaging suggested partial anomalous pulmonary venous connection (PAPVC) and a sinus venosus defect (SVD). She reported exertional dyspnoea, fatigue, paroxysmal nocturnal dyspnoea, longstanding palpitations, and documented runs of atrial tachycardia. Transoesophageal echocardiography demonstrated a dilated right ventricle and pulmonary arteries, mild tricuspid regurgitation, anomalous connection of the right upper and right middle pulmonary veins to the right superior vena cava (SVC), and a persistent left SVC draining to a dilated coronary sinus.<\/jats:p>\n                  <jats:p>Unusually, the interatrial communication consisted of only a small, restrictive fenestration between the SVC and the left atrium. Invasive haemodynamics confirmed a large left\u2010to\u2010right shunt (Qp:Qs 3.3:1) with normal pulmonary artery pressure (mean 19\u2009mmHg). Balloon interrogation demonstrated a restrictive communication and prolapse of the compliant balloon into the pulmonary veins with apparent obstruction, indicating unsuitability for transcatheter correction; the patient underwent surgical repair.<\/jats:p>\n                  <jats:p>We report a previously undescribed SVD in which the interatrial communication is restrictive despite a large shunt carried by the anomalous venous connection and discuss its implications for transcatheter versus surgical decision\u2010making.<\/jats:p>","DOI":"10.1002\/ccd.70921","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:14:19Z","timestamp":1790590459000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Restrictive Superior Vena Cava to Left Atrium Communication With a Large Left\u2010to\u2010Right Shunt: A Previously Undescribed Sinus Venosus Defect Variant"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3423-524X","authenticated-orcid":false,"given":"Ahmed A.","family":"Hassan","sequence":"first","affiliation":[{"name":"Department of Cardiology and Cardiothoracic Surgery Children's Health Ireland at Crumlin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiothoracic Surgery Children's Health Ireland at Crumlin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2021-319334"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951111000710"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.88.6.634"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.124.070271"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab556"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsha.2014.10.001"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26031"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2025.09.006"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.493775"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)62317-X"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.120.009833"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000603"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70921","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70921","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:14:20Z","timestamp":1790590460000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70921"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":12,"alternative-id":["10.1002\/ccd.70921"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70921","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"2026-08-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ccd.70921"}}