Case Of Pulmonary Vein Stenosis Research Articles

Pulmonary Vein Stenosis after Catheter Ablation for Atrial Fibrillation: An Early Diagnosis Using Unenhanced Computed Tomography.

Pulmonary vein stenosis (PVS) is a serious complication of catheter ablation (CA) for atrial fibrillation (AF). PVS generally occurs several months after CA and presents with non-specific symptoms and imaging findings. There have been reports of delayed diagnoses due to a misdiagnosis as infection, interstitial pneumonia, or organizing pneumonia. We introduced six cases of PVS after CA, all of which showed narrowing of the unilateral pulmonary vessels with or without lobar volume loss in the left lung on unenhanced computed tomography. We report these findings as important results indicating the possibility of PVS after CA for AF and contributing to the early diagnosis and management of PVS.

PULMONARY VEIN STENOSIS: A SERIOUS AND UNDERDIAGNOSED COMPLICATION OF PULMONARY VEIN ISOLATION THERAPY

PULMONARY VEIN STENOSIS: A SERIOUS AND UNDERDIAGNOSED COMPLICATION OF PULMONARY VEIN ISOLATION THERAPY

An Unusual Case of Pulmonary Vein Stenosis Diagnosed With Intraoperative Transesophageal Echocardiography.

An Unusual Case of Pulmonary Vein Stenosis Diagnosed With Intraoperative Transesophageal Echocardiography.

Pulmonary Vein Stenosis: A Rare Disease with a Global Reach.

Pulmonary vein stenosis (PVS) is a rare, but high mortality and resource intensive disease caused by mechanical obstruction or intraluminal myofibroproliferation, which can be post-surgical or idiopathic. There are increasing options for management including medications, cardiac catheterization procedures, and surgery. We queried the International Quality Improvement Collaborative for Congenital Heart Disease (IQIC) database for cases of PVS and described the cohort including additional congenital lesions and surgeries as well as infectious and mortality outcomes. IQIC is a quality improvement project in low-middle-income countries with the goal of reducing mortality after congenital heart surgery. Three cases were described in detail with relevant images. We identified 57 cases of PVS surgery, with similar mortality to higher income countries. PVS should be recognized as a global disease. More research and collaboration are needed to understand the disease, treatments, and outcomes, and to devise treatment approaches for low resource environments.

Congenital pulmonary vein stenosis at an African tertiary care centre over a 25-year period

Background: Congenital pulmonary vein stenosis (PVS) is a rare condition, which results from abnormal embryological incorporation of the common pulmonary vein into the left atrium. Methods: A retrospective descriptive case series study was conducted with the aim of describing the characteristics and outcome of children with congenital PVS at an African tertiary care centre over a 25-year period. A computerised paediatric cardiology database initiated in the early 1990s was sourced to identify patients, following which clinical records were retrieved and reviewed. Results: Five cases of congenital PVS were identified between January 1990 and January 2016 and accounted for 0.0007% of all congenital heart defects seen at the centre during the study period. The age at diagnosis ranged from 22 months - 13 years. Most patients presented with respiratory symptoms, with 2 patients presenting with recurrent haemoptysis. The diagnosis of PVS was confirmed by cardiac catheterisation and pulmonary angiography in all patients. All cases were right-sided unilateral PVS and all were associated with one or more congenital heart defects. Mild pulmonary hypertension and elevated capillary wedge pressures were found in all patients. Only one patient underwent specific surgery to relieve the PVS, which subsequently recurred. Another patient underwent a lobectomy following recurrent haemoptysis, but subsequently died of sepsis. Conclusion: Congenital PVS is a rare condition often associated with other congenital cardiac defects. Respiratory symptoms are common at presentation, with haemoptysis forming part of the presenting clinical spectrum, which is in keeping with the published literature. Elevated pulmonary artery pressures and increased ipsilateral pulmonary capillary wedge pressures are a common finding at catheterisation.

Rate of acquired pulmonary vein stenosis after ablation of atrial fibrillation referred to electroanatomical mapping systems: Does it matter?

Thermal injury during radiofrequency ablation (RFA) of atrial fibrillation (AF) can lead to pulmonary vein stenosis (PVS). It is currently unclear if routine screening for PVS by imaging (echocardiography, computed tomography) is clinically meaningful and if there is a correlation between PVS and the electroanatomical mapping system (EAMS) used for the ablation procedure. It was therefore investigated in the current single center experience. All patients from January 2004 to December 2016 with the diagnosis of PVS after interventional ablation of AF by radiofrequency were retrospectively analyzed. From 2004 to 2007, transesophageal echocardiography was routinely performed as screening for RFA-acquired PVS (group A). Since 2008, diagnostics were only initiated in cases of clinical symptoms suggestive for PVS (group B). The overall PVS rate after interventional RFA for AF of the documented institution is 0.72% (70/9754). The incidence was not influenced by screening: group A had a 0.74% PVS rate and group B a 0.72% rate (NS). Referred to as the EAMS, there were significant differences: 20/4229 (0.5%) using CARTO®, 48/4510 (1.1%) using EnSite®, 1/853 (0.1%) using MediGuide®, and 1/162 (0.6%) using Rhythmia®. Since 2009, no significant difference between technologies was found. The present analysis of 9754 procedures revealed 70 cases of PVS. The incidence of PVS is not related to screening but to the application of different EAMS. Possible explanations are technological backgrounds (magnetic vs. electrical), learning curves, operator experience, and work-flow differences. Furthermore, incorporation of new technologies seems to be associated with higher incidences of PVS before workflows are optimized.

Complex treatment of recurrent pulmonary vein stenosis

Pulmonary vein stenosis (PVS) in children is a rare heart disease characterized by high recurrence and mortality rates.
 Objective. We describe a case of recurrent PVS, which was treated surgically and subsequently with repeated balloon angioplasties.
 Materials and methods. Echocardiogram showed total anomalous pulmonary venous connection, mixed form. A CT scan of the chest confirmed the diagnosis. Month later after initial surgery angiography detected the presence of stenosis in all pulmonary veins.
 Results. Currently patient has moderate residual stenosis in each PV. His prognosis is considered bleak due to continuous requirement in aggressive interventions in order at least temporarily resolve pulmonary vein stenosis.
 Conclusions. Pulmonary vein stenosis still bears high recurrence, reintervention and mortality rates. Rigorous surveillance and combination of surgical and interventional treatment is warranted in this subset of patients to maintain quality of life.

A case report of acute pulmonary vein stenosis

Hemoptysis is a common emergency symptom for pulmonary embolism. It's important to differential diagnosis for this symptom. This article reports a case of pulmonary vein stenosis. The patient was transferred to a number of hospitals for medical treatment, but was misdiagnosed for 7 months. This article aims to improve clinician's ability to differentially diagnose hemoptysis, and to deepen the knowledge of pulmonary vein stenosis.

Pulmonary Vein Stenosis in a Newborn: A Commonly Overlooked Diagnosis.

The diagnosis of primary pulmonary vein stenosis is often overlooked because its symptoms overlap lung diseases and pulmonary arterial hypertension. Its diagnosis may be difficult because the condition is progressive and associated with other defects. We present a case of pulmonary vein stenosis in a newborn with stenosis of the left-sided common pulmonary vein, diffuse hypoplasia of the superior right pulmonary vein, and atresia of the inferior right pulmonary vein.

The first reported case of pulmonary vein stenosis treated by percutaneous angioplasty with self-apposing drug-eluting stent implantation

A 52-year-old male who had suffered from dyspnea on exertion since last year was diagnosed with recurrent paroxysmal atrial fibrillation (PAF). An echocardiography examination (ECHO) conducted during that period revealed borderline right ventricular systolic pressure (RVSP, 30–35mmHg), without any other abnormalities. Percutaneous radiofrequency (RF) ablation for PAF was performed. Despite the reduction of arrhythmic episodes, the symptoms noticeably developed a couple of weeks after the procedure.

Pulmonary Venous Stenosis on Ventilation-Perfusion Scintigraphy

A case of pulmonary vein stenosis as a result of prior atrial fibrillation focus procedures for atrial fibrillation, correlated with magnetic resonance (MR) pulmonary angiography, is presented. Restricted flow to the right lung in similar quantities measured by nuclear medicine and MR techniques is observed, with perfusion scintigraphy demonstrating decreased but not absent flow to the right lung and left lower lobe and with MRI demonstrating restriction of flow through the right and left lower pulmonary veins. The sharp differences in venous outflow can be seen by MR, whereas their effects are visible by scintigraphy.

Pulmonary vein stenosis after radiofrequency ablation of lone atrial fibrillation in an ironman triathlete

Regular participation in intense sports activities increases the risk of developing atrial fibrillation (AF). Pulmonary vein (PV) ablation in athletes with AF is an effective therapy but may also expose them to complications. We report the first case of PV stenosis after radiofrequency (RF) ablation of lone AF in a young endurance athlete.

A Case of Pulmonary Vein Stenosis After Catheter Ablation for Atrial Fibrillation

A Case of Pulmonary Vein Stenosis After Catheter Ablation for Atrial Fibrillation

Real-time Assessment of Oesophageal Position by Direct Visualisation with Luminal Contrast—Implications FOR Catheter Ablation Strategy

(one persisting beyond one year), six minor haemoptysis, three fluid overloads, one pneumonia and one transient visual field loss. There were two (0.9%) major complications; onepersistinggastroparesis andone lobectomy secondary to pulmonary infarction. There were no observed cases of pulmonary vein stenosis (PVS), stroke, pericardial tamponade/effusion or atrio-oesophageal fistula (AOF). Conclusion: The majority of pulmonary veins can be isolated using the CBA technique alone. Procedure and fluoroscopy times fall significantly with operator experience to around 130minutes and 30minutes respectively. The safety profile compares favourably to radiofrequency ablation with no PVS, AOF or stroke in our series. doi:10.1016/j.hlc.2011.05.262

Regional Loss of the V Wave During the Measurement of Pulmonary Artery Wedge Pressure as a Clue to Pulmonary Vein Stenosis

INTRODUCTION: Pulmonary vein stenosis (PVS) following radiofrequency ablation (RFA) for symptomatic atrial fibrillation (AF) poses a diagnostic challenge for clinicians. Symptoms, signs and radiographic findings of PVS are nonspecific and can be attributed incorrectly to pneumonia, thromboembolism or interstitial lung disease. For this reason, identification of clues to the diagnosis of PVS is important. We report a case of PVS with pulmonary hypertension (PH) where the presence and location of PVS was suggested by the observation of regional loss of a V wave during the measurement of pulmonary artery wedge pressure.

Acquired Pulmonary Vein Stenosis: One Problem, Two Mechanisms

Until the last decade, acquired pulmonary vein (PV) stenosis in the adult population was a rare finding, caused by neoplasm or inflammatory conditions such as sarcoidosis or fibrosing mediastinitis. With the increased use of catheter-based ablation for the treatment of atrial fibrillation, PV stenosis is increasingly recognized as a complication of this procedure. Additionally, PV stenosis has been described as a rare complication of cardiac surgery. This report describes two cases of PV stenosis, one acquired as a result of multiple left atrial ablation procedures and the other after surgical cannulation of the right upper PV.

Transesophageal Echocardiography in Comparison with Magnetic Resonance Imaging in the Diagnosis of Pulmonary Vein Stenosis after Radiofrequency Ablation Therapy

Doppler-derived flow velocity measured by transesophageal echocardiography (TEE) may overestimate pulmonary vein stenosis. We hypothesized that combining peak velocity with a stenotic flow pattern improves diagnosis compared with magnetic resonance imaging (MRI). TEE and MRI were performed in 44 patients 19 +/- 11 months after radiofrequency catheter ablation. Pulmonary vein stenosis was defined by a peak velocity of 110 cm/s or more plus a stenotic flow pattern (turbulence and reduced flow variation) on TEE and a lumen reduction of more than 50% on MRI. In all, 175 pulmonary veins were studied. MRI showed 7 cases of pulmonary vein stenosis that were correctly identified by TEE. In addition, TEE criteria for pulmonary vein stenosis were met in 4 pulmonary veins that did not show obstruction on MRI. In all, 5 pulmonary veins with normal appearance on MRI had peak velocity of 110 cm/s or more with normal flow pattern. TEE Doppler measurements can be reliably used to detect or exclude significant pulmonary vein stenosis if the diagnosis is restricted to a combination of elevated peak velocity (> or = 110 cm/s) with turbulence and little flow variation.