Open Access

ARTICLE

Interventional Treatment of Abnormal Veins Following Surgical Repair of Complex Congenital Heart Disease

Zhengwei Li^1,#, Xin Li^2,#, Dong Luo¹, Meijun Liu¹, Luxi Guan¹, Haibo Hu^1,*
1 Center of Structural Heart Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
2 Center of Pulmonary Vascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
* Corresponding Author: Haibo Hu. Email:
# These authors contributed equally to this work

Congenital Heart Disease https://doi.org/10.32604/chd.2026.069714

Received 29 June 2025; Accepted 16 December 2025; Published online 05 February 2026

Abstract

Background: During the surgical repair of complex congenital heart disease (CCHD), a subset of patients is unable to tolerate abrupt postoperative hemodynamic shifts, which can lead to significant complications. To mitigate this risk, certain abnormal venous channels are deliberately left open at the conclusion of surgery to provide a decompressive route, thereby reducing the likelihood of pulmonary hypertensive crises. Nevertheless, the continued patency of these vessels may induce chronic hemodynamic disturbances, often requiring subsequent treatment. This study was designed to assess the safety and efficacy of transcatheter intervention for such persistent anomalous systemic veins in CCHD patients following initial corrective operation. Methods: We performed a retrospective review of 14 CCHD patients who underwent transcatheter closure of residual anomalous systemic veins—including azygos, hemiazygos, and vertical veins—after prior corrective surgery at Fuwai Hospital from December 2007 to September 2019. Results: All procedures were completed successfully. Following closure of the azygos or hemiazygos veins, femoral arterial oxygen saturation increased significantly (S_FAO₂: 87.0 ± 2.7% vs. 75.1 ± 3.7%, p < 0.001). Mean pulmonary arterial pressure (mPAP) rose slightly but statistically significantly post-intervention, although it remained within normal limits (12.3 ± 2.7 mmHg vs. 10.8 ± 3.3 mmHg, p = 0.027). In the two patients undergoing vertical vein closure, S_FAO₂ also improved markedly (Case 13: 98% vs. 86%; Case 14: 99% vs. 88%). Over a mean follow-up period of 26.3 ± 13.9 months, all patients remained clinically stable without major adverse events. Conclusions: Transcatheter closure of residual anomalous systemic veins after corrective surgery for CCHD is a safe and effective therapeutic option, associated with high procedural success and favorable short- to mid-term clinical outcomes.

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Keywords

Azygos vein; hemiazygos vein; vertical vein; transcatheter closure

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