In a significant breakthrough in cardiac care in South Tamil Nadu, Meenakshi Super Speciality Hospital successfully treated a 64-year-old farmer with a rare congenital heart defect, known as sinus venosus atrial septal defect (ASD), using a minimally invasive transcatheter technique, avoiding the need for open-heart surgery.
The patient presented with progressive breathlessness on exertion, easy fatigability, and palpitations, which worsened over time and began to interfere with his daily activities. A comprehensive cardiac evaluation, including a Transthoracic Echocardiogram (a non-invasive ultrasound performed over the chest), a Transesophageal Echocardiogram (which uses a probe passed through the food pipe for clearer visualisation of the heart), and a Cardiac CT scan, revealed a previously undiagnosed congenital heart condition: sinus venosus ASD.
This defect resulted in a left-to-right shunt, where oxygen-rich blood flowed abnormally into the right side of the heart. Over time, this led to right ventricular (RV) volume overload, causing the right side of the heart to enlarge and work harder than normal, ultimately explaining the patient’s symptoms.
Though sinus venosus ASD is conventionally treated with open-heart surgery, the medical team opted for an innovative, less invasive alternative. The patient underwent a transcatheter closure using a covered stent, a procedure in which a specially designed stent is delivered through a blood vessel to seal the defect and restore normal blood flow.
The procedure was performed by Dr. R. Sivakumar, Senior Consultant and HOD - Cardiology, supported by Dr. S. Kumar, Chief Cardiac Anaesthetist and catheterisation lab team. After the procedure, the patient was monitored in the ICU for 24 hours and discharged after a routine ward care. He was advised to ensure regular cardiac follow-up, adherence to antiplatelet therapy, and strict control of comorbid conditions such as hypertension and diabetes.
In his comments, Dr R. Sivakumar, Head of Department and Director of Structural Interventions, Department of Cardiac Sciences said, “When he presented to us, we conducted a comprehensive cardiac evaluation using non-invasive ultrasound, advanced echocardiography, and cardiac CT, which revealed a rare congenital condition, sinus venosus ASD. This case is among the few in the region where a sinus venosus ASD has been successfully treated using a transcatheter covered stent approach. Traditionally requiring open-heart surgery, this condition was managed safely through a minimally invasive technique guided by advanced cardiac imaging, reducing procedural risk and enabling faster recovery. It highlights the growing role of covered stent technology in treating complex structural heart diseases, particularly in elderly patients, and marks a significant achievement in the region.”
He added that with evolving technologies, many complex heart conditions can now be managed without open surgery. But early diagnosis is important. The symptoms such as breathlessness on exertion, fatigue, palpitations, or swelling of the legs should not be ignored. Early treatment can prevent serious complications, including pulmonary hypertension, and significantly improve quality of life.
Mr. Dileep Bernard from the hospital and Dr. S. Kumar, Chief Cardiac Anaesthetist, Dr. N. Ganesan, Director of Academics, Dr. S. Selvamani, Director of Interventional Cardiology, Dr. M. Sampath Kumar, Lead in Paediatric Cardiology, and Dr. Jeyapandian, Lead in Electrophysiology, Senior Interventional Cardiologist, Dr. Thomas Xavier, Associate Consultant Cardiologist, Department of Cardiac Sciences, were also present.