Stent implantation for severe pulmonary vein stenosis or occlusion secondary to atrial fibrillation ablation

Li, Yanjie; Pan, Xin; Wang, Cheng; He, Ben

doi:10.1016/j.ijcard.2019.11.147

Cited by 9 publications

(7 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PVS after radiofrequency ablation is an uncommon but serious complication [6]. In symptomatic cases, PVS stenting can provide hemodynamic relief of pulmonary circulation [2]. However, like our patient, who had a bleeding complication and relative contraindication to chronic oral anticoagulation with warfarin or NOACs, the potential risk of LAA thrombosis and concomitant stroke are challenging.…”

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Combined pulmonary vein stenosis stenting and left atrial appendage occlusion in a patient with hemoptysis after atrial fibrillation ablation

Pan

Wang

et al. 2020

BMC Cardiovasc Disord

Self Cite

View full text Add to dashboard Cite

Background: Pulmonary vein stenosis (PVS) after radiofrequency ablation for non-valvular atrial fibrillation (AF) is an uncommon but serious complication. PVS stenting can rapidly restore pulmonary flow and improve symptoms with long-term low incidence of restenosis. However, high risk of thrombosis remains if AF is recurrent, especially for CHA 2 DS 2-VASc > 2. Case presentation: A 67-year-old man with diabetes, hypertension and a history of stroke underwent radiofrequency pulmonary vein isolation for persistent AF 1 year ago. Six months later he developed recurrent respiratory infection and massive hemoptysis. Computed tomography pulmonary angiography revealed severe left pulmonary vein stenosis. Simultaneous percutaneous PVS stenting and left atrial appendage occlusion were performed to resolve recurrent hemoptysis and prevent stroke. The clinical follow-up indicated a good short and mid-term result with significant improvement of symptoms. Conclusions: Simultaneous PVS stenting and left atrial appendage occlusion is feasible and effective in patients with recurrence of AF and hemoptysis induced by radiofrequency ablation for AF.

show abstract

Section: Discussionmentioning

confidence: 94%

“…Pulmonary vein stenosis (PVS) is an uncommon but potentially serious complication following catheter ablation for atrial fibrillation (AF) [1]. Obviously, in symptomatic cases with severe PVS, early PVS stenting is needed to restore pulmonary flow [2,3]. However, high risk of cardiac thrombosis remains if AF is recurrent.…”

Section: Introductionmentioning

confidence: 99%

Combined pulmonary vein stenosis stenting and left atrial appendage occlusion in a patient with hemoptysis after atrial fibrillation ablation

Pan

Wang

et al. 2020

BMC Cardiovasc Disord

Self Cite

View full text Add to dashboard Cite

show abstract

“…In several studies, the rate of restenosis has been shown to be lower with stenting than with balloon angioplasty [ 6 , 12 ]. In one case series of 56 patients with RFA-induced PV stenosis, stenting was found to be 95.8% successful, with significantly improved pressure gradients, vessel caliber, and symptoms [ 13 ]. Bare metal stents (which were used in our patient) have been shown to have a lower rate of restenosis than drug eluting stents [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Vein Stenosis and Pulmonary Hypertension Following a Catheter-Based Radiofrequency Ablation for Atrial Fibrillation: A Case Report

et al. 2020

View full text Add to dashboard Cite

Patient: Male, 78-year-old Final Diagnosis: Pulmonary vein stenosis Symptoms: Dyspnea Medication:— Clinical Procedure: Radiofrequency ablation • stenting of the pulmonary vein Specialty: Pulmonology Objective: Unusual clinical course Background: Pulmonary vein (PV) stenosis is a rare condition characterized by progressive luminal size reduction of one or more pulmonary veins (PVs), which can increase postcapillary pressure resulting in shortness of breath, cough, hemoptysis, and pulmonary hypertension (PH). The diagnosis of PV stenosis requires a high degree of suspicion. PV stenosis is a rare but recognized complication of catheter-based radiofrequency ablation (RFA) for atrial fibrillation (AF). Case Report: We present a case of a 78-year-old man who underwent a surgical MAZE procedure followed by catheter-based RFA to treat AF. He subsequently developed shortness of breath, exercise limitation, and PH. The patient was ultimately diagnosed with PV stenosis, which was a sequela of the RFA and the cause of his PH. The patient was treated by stenting of his PV, with improvement in his exercise capacity and PH. Follow-up imaging showed improved pulmonary blood flow and reduced pulmonary pressures. Conclusions: We conclude that PV stenosis should be high in the differential as the cause of dyspnea in patients with PH and a previous history of RFA for AF management. Early recognition and treatment can prevent complete occlusion of the affected PV and lead to an improvement in the patient’s symptoms and quality of life.

show abstract

“…There is evidence indicating that stent implantation with balloon dilatation is characterized by a better short-term outcome and lower risk of PV restenosis compared with PTA alone. 2 , 6 Indeed, more than 50% of patients will experience an early restenosis after PTA alone, 2 , 4 , 6 whereas this early risk is much lower with 16–33% after a stent placement depending on the stent size. Large-diameter stents (≥8 mm) may have a lower risk of restenosis (6.4%).…”

Section: Introductionmentioning

confidence: 99%

Partially reversible lung consolidation after revascularization of a total occlusion of both left pulmonary veins following ablation of atrial fibrillation: a case report

Ahero¹,

Frauenfelder²,

Berndt³

et al. 2023

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Background The use of pulmonary vein radiofrequency ablation for atrial fibrillation treatment may be complicated by pulmonary vein stenosis or occlusion. A common curative treatment for symptomatic patients is a transcatheter intervention, including percutaneous transluminal balloon angioplasty and stent implantation. Stent implantation itself, however, can be complicated by in-stent stenosis. Case Summary A 26-year-old man presented with worsening exertional dyspnoea due to a total occlusion of both left pulmonary veins after the isolation of two pulmonary veins for atrial fibrillation. Chest computed tomography (CT) showed chest asymmetry and consolidation of the left lung. The patient was treated with balloon angioplasty and stent placement of both left pulmonary veins, resulting in improvement of symptoms, walking distance, and increase in lung space volume by 120 mL based on CT-based volumetry. Ten months later the patient experienced a recurrence of similar symptoms. A high grade in stent restenosis of the upper left pulmonary vein and moderate in stent restenosis of the lower pulmonary vein was diagnosed and was treated with angioplasty. The patient was discharged from the hospital in good clinical conditions 3 days after the intervention. Discussion Non-specific symptoms of pulmonary vein stenosis or occlusion, such as shortness of breath, fatigue, flu like symptoms, reduced physical performance and haemoptysis delay the diagnosis. If unusual symptoms appear abruptly after pulmonary vein isolation, a pulmonary vein stenosis should be considered. In this case, we describe for the first time a partially reversible consolidation of lung parenchyma following the revascularisation of both pulmonary veins.

show abstract

Stent implantation for severe pulmonary vein stenosis or occlusion secondary to atrial fibrillation ablation

Cited by 9 publications

References 19 publications

Combined pulmonary vein stenosis stenting and left atrial appendage occlusion in a patient with hemoptysis after atrial fibrillation ablation

Combined pulmonary vein stenosis stenting and left atrial appendage occlusion in a patient with hemoptysis after atrial fibrillation ablation

Pulmonary Vein Stenosis and Pulmonary Hypertension Following a Catheter-Based Radiofrequency Ablation for Atrial Fibrillation: A Case Report

Partially reversible lung consolidation after revascularization of a total occlusion of both left pulmonary veins following ablation of atrial fibrillation: a case report

Contact Info

Product

Resources

About