Primary Pulmonary Vein Stenosis

Holt, D. Byron; Moller, James H.; Larson, Sarah; Johnson, Mark C.

doi:10.1016/j.amjcard.2006.09.100

Cited by 87 publications

(103 citation statements)

References 16 publications

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“…As a result of the raised awareness of PVS, more cases of milder forms are being diagnosed in relatively asymptomatic patients (2). Given that Holt et al (8) reported initial mean pulmonary arterial pressure to be an independent predictor of lung death in PVS patients, early diagnosis may lead to improved survival for these individuals. The authors also reported that patients presenting in infancy should be considered at high risk for mortality, regardless of the number of veins involved (8).…”

Section: Discussionmentioning

confidence: 99%

“…There is debate as to whether the number of pulmonary veins involved and the degree of obstruction affects the onset and severity of presentation (2,8). Symptoms of pulmonary hypertension are not typical at early presentation -patients often present with tachypnea and recurrent pneumonia instead (2).…”

Section: Discussionmentioning

confidence: 99%

“…Given that Holt et al (8) reported initial mean pulmonary arterial pressure to be an independent predictor of lung death in PVS patients, early diagnosis may lead to improved survival for these individuals. The authors also reported that patients presenting in infancy should be considered at high risk for mortality, regardless of the number of veins involved (8). Therefore, our patient had a significantly elevated risk of mortality given her young age at presentation and suprasystemic pulmonary pressures.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary Vein Stenosis: Case Report and Literature Review

Amin

Kwon

Moayedi

et al. 2009

Canadian Respiratory Journal

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BACKGROUND: Pulmonary vein stenosis is a rare cause of pulmonary hypertension, with variable onset and presentation. One or more of the four pulmonary veins can be primarily or secondarily affected. A five-month-old girl presented with respiratory distress, lethargy and cyanosis requiring intubation.METHODS: Echocardiography showed right ventricular dilation, a right ventricular systolic pressure of 97 mmHg, decreased ejection fraction and turbulent flow at the left atrium. Cardiac catheterization revealed stenosis of the left-sided pulmonary veins, for which she underwent a Coles procedure.RESULTS: Postoperatively, there was a transient improvement in the patient’s pulmonary hypertension but she subsequently deteriorated. Her prognosis was considered bleak, and a decision was made with the family to withdraw care.CONCLUSION: Pulmonary vein stenosis is a rare cause of pulmonary hypertension, and is associated with significant morbidity and mortality. Surgical intervention may be of benefit in selected cases. It stands to reason that any treatment will have the best chance of success if completed before the pulmonary hypertension becomes fixed. Early diagnosis depends on a high index of clinical suspicion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pulmonary Vein Stenosis: Case Report and Literature Review

Amin

Kwon

Moayedi

et al. 2009

Canadian Respiratory Journal

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“…[26][27][28] Acquired, adult onset pulmonary vein stenosis is seen very rarely in a few conditions such as fibrosing mediastinis, neoplasm, or sarcoidosis, and management has been reported sparingly, mostly in isolated case reports, with mixed results. 29,30 The larger experience with congenital pulmonary vein stenosis was fairly dismal with universally high recurrence rates and high mortality with both transcatheter and surgical intervention.…”

Section: Percutaneous Intervention For Pulmonary Vein Stenosismentioning

confidence: 99%

“…29,30 The larger experience with congenital pulmonary vein stenosis was fairly dismal with universally high recurrence rates and high mortality with both transcatheter and surgical intervention. [26][27][28] In particular, stenting congenitally stenotic pulmonary veins had been essentially abandoned after a handful of studies documented very poor results 31,32 With that background in mind, though realizing the pathophysiology was different, we felt we should approach this problem initially in the least invasive manner in the form of balloon angioplasty for significantly symptomatic patients. We quickly encountered high recurrence rates in the order of 70% after balloon dilation, but did observe tempowww.jafib.com 30 Jan-Feb, 2010 | Vol 2 | Issue 4 [ Figure 4].…”

Section: Percutaneous Intervention For Pulmonary Vein Stenosismentioning

confidence: 99%

The State of the Art in Pulmonary Vein Stenosis - Diagnosis & Treatment

Prieto¹

2010

J.A.F.I.B

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Pulmonary vein stenosis is a rare but serious complication of pulmonary vein isolation to treat atrial fibrillation. Pulmonary vein angioplasty/stenting has emerged as the treatment of choice for significantly stenotic veins. Guidelines for post ablation evaluation of the pulmonary veins, including the timing and method of surveillance for possible stenosis, the criteria for intervention, the technical aspects of intervention, and finally the surveillance post intervention, are still being developed. The relatively high rate of restenosis after intervention in a subset of patients remains a great challenge. A better understanding of the pathophysiology underlying this syndrome is needed to appropriately answer many of the remaining questions. The goal of this manuscript is to describe what has been learned about this complication and its treatment from a relatively large experience in a single institution over the past decade, and provide a comprehensive review of the existing literature in order to shed as much light on the subject as is possible, while at the same time exposing the areas that need further study.www.jafib.com 27 Jan-Feb, 2010 | Vol 2 | Issue 4 decline. [9][10][11][12][13][14][15] Recognizing that there is no consensus at this time on routine screening for pulmonary vein stenosis after PVI, 16 we followa protocol at our institution to assure that the small number of patients who still develop significant pulmonary vein stenosis is not missed. Imaging is performed 3 months following PVI, and repeated 3 months later only if significant stenosis is detected at the time of the first scan.Detailed anatomy of the pulmonary veins is best defined by electrocardiographically (ECG)-gated contrast-enhanced multidetector computed tomogram (MDCT) [ Figure 1]. Frequently, images are acquired with retrospectively gated helical scanning. However, despite the use of dosemodulation, these protocols are associated with higher radiation exposure. Therefore, with recent advances in scanner technology, there is a trend to scanning with prospectively triggered protocols in patients with controlled heart rate. In those patients with fast and irregular heart rate, scanning with spiral non-gated imaging is a good alternative. Images are reconstructed with overlapping 1.00-to 1.25-mm slice thickness for analysis with multiplanar reconstructions, maxi mal intensity projections, and volume rendered imaging. Semi-automated analysis and display software supports the evaluation of the images.Cardiac MRI is an excellent alternative modality, and avoids exposure to ionizing radiation. It has been used in clinical care and clinical research, but is more expensive (at least in the United States) and time-consuming.17 Transesophageal echocardiography has been considered as a screening tool also to avoid radiation exposure, but it is not always possible to evaluate each pulmonary vein with 100% sensitivity when compared to MDCT, and it is not possible to evaluate the anatomy in detail if an interventional procedure is necess...

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Cor Triatriatum Sinister, Pulmonary Vein Stenosis, Atresia of the Common Pulmonary Vein, and Cor Triatriatum Dexter

Delius

Walters

2012

Pediatric Cardiac Surgery

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Primary Pulmonary Vein Stenosis

Cited by 87 publications

References 16 publications

Pulmonary Vein Stenosis: Case Report and Literature Review

Pulmonary Vein Stenosis: Case Report and Literature Review

The State of the Art in Pulmonary Vein Stenosis - Diagnosis & Treatment

Cor Triatriatum Sinister, Pulmonary Vein Stenosis, Atresia of the Common Pulmonary Vein, and Cor Triatriatum Dexter

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