Drug-Coated Balloon Angioplasty in Pulmonary Vein Stenosis

Ghobrial, Joanna

doi:10.1016/j.jaccas.2023.102021

Cited by 2 publications

(2 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since the rate of in-stent restenosis of pulmonary veins remains high, a combination of larger stents (currently only available in the bare metal form) and drug delivery using DCB may prove to be a suitable combination to improve the rate of long-term patency and reduce the re-intervention rate. 11 While the use of DCB angioplasty has been reported in pulmonary vein stenosis following radiofrequency ablation, the use of DCB in anomalous pulmonary veins and pericardial baffle repairs has not been reported in the literature. 12 …”

Section: Discussionmentioning

confidence: 99%

Transcatheter management of obstructed baffle repairs of partial anomalous pulmonary veins: a case series

Das,

Blazevic,

Mehra

et al. 2024

European Heart Journal - Case Reports

Self Cite

View full text Add to dashboard Cite

Structured Abstract Background Partial anomalous pulmonary venous return (PAPVR) can be surgically corrected using a pericardial baffle. This baffle can become obstructed post-surgery, leading to pulmonary hypertension and right heart dysfunction if not detected and corrected. Case Summary We describe three patients with occluded PAPVR baffles who underwent drug-coated balloon angioplasty and stenting of the obstructed baffle. In each case, baffle obstruction was detected post-operatively on surveillance cross-sectional imaging, and an invasively measured pulmonary capillary wedge-to-left atrium gradient was noted to be elevated. Post-intervention, each patient had an improvement in baffle flow by angiography as well as lung perfusion as assessed by nuclear medicine scintigraphy. Discussion Given the subtle symptomatology of obstructed PAPVR pericardial baffle repairs, surveillance imaging is necessary to detect occluded baffles and intervene before downstream right heart disease and pulmonary hypertension develops. Given the high rates of re-stenosis in pulmonary vein stenting, pre-treatment of occluded PAPVR baffles with drug coated balloons may help reduce re-intervention rates.

show abstract

Section: Discussionmentioning

confidence: 99%

Transcatheter management of obstructed baffle repairs of partial anomalous pulmonary veins: a case series

Das,

Blazevic,

Mehra

et al. 2024

European Heart Journal - Case Reports

Self Cite

View full text Add to dashboard Cite

show abstract

“…Diagnosis and management of primary PVS is frequently challenged by coexisting congenital cardiac malformations, seen in up to 50% of patients with primary PVS, which complicate disease management and interventional approaches ( 8 ). Catheter-based interventions of PVS, including balloon angioplasty ( 15 ) and endovascular stenting ( 16 ) in PVS, have historically been burdened with significant rates of restenosis and pulmonary regurgitation ( 5 , 17 ). The recent increase in the use of drug-eluting stents has shown initial promise for improving the rates of in-stent restenosis ( 18 ); however, stent placement is not always feasible due to severe stenosis or venous anatomy ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Patient-specific 3D in vitro modeling and fluid dynamic analysis of primary pulmonary vein stenosis

Devlin,

Tomov,

Chen

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

IntroductionPrimary pulmonary vein stenosis (PVS) is a rare congenital heart disease that proves to be a clinical challenge due to the rapidly progressive disease course and high rates of treatment complications. PVS intervention is frequently faced with in-stent restenosis and persistent disease progression despite initial venous recanalization with balloon angioplasty or stenting. Alterations in wall shear stress (WSS) have been previously associated with neointimal hyperplasia and venous stenosis underlying PVS progression. Thus, the development of patient-specific three-dimensional (3D) in vitro models is needed to further investigate the biomechanical outcomes of endovascular and surgical interventions.MethodsIn this study, deidentified computed tomography images from three patients were segmented to generate perfusable phantom models of pulmonary veins before and after catheterization. These 3D reconstructions were 3D printed using a clear resin ink and used in a benchtop experimental setup. Computational fluid dynamic (CFD) analysis was performed on models in silico utilizing Doppler echocardiography data to represent the in vivo flow conditions at the inlets. Particle image velocimetry was conducted using the benchtop perfusion setup to analyze WSS and velocity profiles and the results were compared with those predicted by the CFD model.ResultsOur findings indicated areas of undesirable alterations in WSS before and after catheterization, in comparison with the published baseline levels in the healthy in vivo tissues that may lead to regional disease progression.DiscussionThe established patient-specific 3D in vitro models and the developed in vitro–in silico platform demonstrate great promise to refine interventional approaches and mitigate complications in treating patients with primary PVS.

show abstract

Drug-Coated Balloon Angioplasty in Pulmonary Vein Stenosis

Cited by 2 publications

References 23 publications

Transcatheter management of obstructed baffle repairs of partial anomalous pulmonary veins: a case series

Transcatheter management of obstructed baffle repairs of partial anomalous pulmonary veins: a case series

Patient-specific 3D in vitro modeling and fluid dynamic analysis of primary pulmonary vein stenosis

Contact Info

Product

Resources

About