Medical and Invasive Management of Congenital and Acquired Pulmonary Vein Stenosis

Patel, Jay; Briones, Michael; Jones, Shannon; Suthar, Divya; Gray, Rosemary; Petit, Christopher J.

doi:10.1007/s40746-020-00198-0

Cited by 4 publications

(4 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Degree of stenosis or atresia for each individual vein was defined by our previously described PVS grading scheme (Figure 1). 16 Grade 1 pulmonary veins were considered mildly stenotic with narrowest measurement >50% of the distal vein diameter. Grade 2 pulmonary veins are defined as PVS with a narrowest diameter measurement of <50% when compared with the distal vein caliber.…”

Section: Methodsmentioning

confidence: 99%

Transcatheter Recanalization of Atretic Pulmonary Veins in Infants and Children

Patel

Mandhani

Gray

et al. 2022

Circ: Cardiovascular Interventions

Self Cite

View full text Add to dashboard Cite

Background: Pulmonary vein stenosis is a progressive disease associated with a high rate of mortality in children. If left untreated, myofibroblastic proliferation can lead to pulmonary vein atresia (PVA). In our experience, transcatheter recanalization has emerged as a favorable interventional option. We sought to determine the acute success rate of recanalization of atretic pulmonary veins and mid-term outcomes of individual veins after recanalization. Methods: We reviewed all patients with PVA at our institution between 2008 and 2020 diagnosed by either catheterization or cardiac computed tomography. All veins with successful recanalization were reviewed and procedural success rate and patency rate were noted. Competing risk analysis was performed to demonstrate outcomes of individual atretic veins longitudinally. Results: Between 2008 and 2020, our institution diagnosed and treated 131 patients with pulmonary vein stenosis. Of these, 61 patients developed atresia of at least one pulmonary vein. In total, there were 97 atretic pulmonary veins within this group. Successful recanalization was accomplished in 47/97 (48.5%) atretic veins. No atretic pulmonary veins were successfully recanalized before 2012. The majority of veins were recanalized between 2017 and 2020—39/56 (70%). The most common intervention after recanalization was drug-eluting stent placement. At 2-year follow-up 42.6% of recanalized veins (20.6% of all atretic veins) remained patent with a median of 4 reinterventions per person. Conclusions: Transcatheter recanalization of PVA can result in successful reestablishment of flow to affected pulmonary veins in many cases. Drug-eluting stent implantation was the most common intervention performed immediately post-recanalization. Vein patency was maintained in 42.6% of patients at 2-year follow-up from recanalization with appropriate surveillance and reintervention. Overall, only a small portion of atretic pulmonary veins underwent successful recanalization with maintained vessel patency at follow-up. Irrespective of successful recanalization, there was no detectable survival difference between the more recently treated PVA cohort and non-PVA cohort.

show abstract

Section: Methodsmentioning

confidence: 99%

Transcatheter Recanalization of Atretic Pulmonary Veins in Infants and Children

Patel

Mandhani

Gray

et al. 2022

Circ: Cardiovascular Interventions

Self Cite

View full text Add to dashboard Cite

show abstract

“…As with CTA, angiographic scoring systems have been developed to characterize the severity of disease in each pulmonary vein. 10,40 The baseline vein score and involved vessel location were shown to correlate with vein outcome in a study evaluating the use of imatinib mesylate in a cohort of patients with multivessel PVS. 10 Further, Patel et al 40 have developed a thoughtful PVS scoring system to standardize the language for describing PVS.…”

Section: Angiographymentioning

confidence: 99%

Management of Pediatric Pulmonary Vein Stenosis

Callahan

Morray

Hirsch

et al. 2022

Journal of the Society for Cardiovascular Angiography & Int

Self Cite

View full text Add to dashboard Cite

“…Based upon our review of prior studies, we felt strongly that immunomodulatory therapy would be a critical component to our PVS Program. We also sought to make uniform the follow-up, surveillance imaging, and reintervention necessary to improve survival for this at-risk cohort [9,10].…”

Section: Pvs Programmentioning

confidence: 99%

“…For patients whose worst PVs are grade 2 (>50% stenosis), repeat intervention is planned for 6-12 weeks from intervention. Timing of repeat intervention and surveillance catheterization is based upon the interval CTA, the patient's clinical appearance, and the RV pressure estimated by echocardiography [10]. We have previously reported a treatment algorithm used at our institution [24].…”

Section: Anatomic Therapymentioning

confidence: 99%

Pulmonary Vein Stenosis in Children: A Programmatic Approach Employing Primary and Anatomic Therapy

Kuo

Petit

2021

Children

Self Cite

View full text Add to dashboard Cite

Pulmonary vein stenosis (PVS) is a difficult condition to treat due to recurrence and progression. In 2017, we developed a comprehensive PVS Program at our center to address the multidisciplinary needs of these patients. We discuss the components of our program and our approach to these patients, using a combination of primary (medical) therapy in addition to anatomic therapy to preserve vessel patency. A multidisciplinary approach to treating these challenging patients is critical.

show abstract

Medical and Invasive Management of Congenital and Acquired Pulmonary Vein Stenosis

Cited by 4 publications

References 39 publications

Transcatheter Recanalization of Atretic Pulmonary Veins in Infants and Children

Transcatheter Recanalization of Atretic Pulmonary Veins in Infants and Children

Management of Pediatric Pulmonary Vein Stenosis

Pulmonary Vein Stenosis in Children: A Programmatic Approach Employing Primary and Anatomic Therapy

Contact Info

Product

Resources

About