Outcomes and prognostic factors for postsurgical pulmonary vein stenosis in the current era

Kalfa, David; Belli, Emrè; Bacha, Emile A.; Lambert, Virginie; Carlo, Duccio Di; Kostolny, Martin; Nosál, Matej; Hörer, Jürgen; Salminen, Jukka; Rubay, Jean; Yemets, Illya; Hazekamp, Mark G.; Maruszewski, Bohdan; Sarris, George E.; Berggren, Håkan; Ebels, Tjark; Başer, Onur; Lacour-Gayet, François

doi:10.1016/j.jtcvs.2018.02.038

Cited by 55 publications

(42 citation statements)

References 26 publications

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“…Echocardiography. Each PV was assessed by echocardiography according to a standardized imaging protocol described by Kalfa et al [6], consisting of three components: (1) severity of disease measured by mean echocardiographic pressure gradient and (2) extent of stenosis in each individual pulmonary vein (PV) and (3) uni-or bilateral extent of the disease. ECHSA Score was used to summarize the findings.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Echocardiography and Computed Tomography/Magnetic Resonance Imaging for Assessing of Pulmonary Vein Stenosis in Children

Mykychak¹,

Kozhokar²,

Yusifli³

et al. 2020

ujcvs

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Pulmonary vein (PV) stenosis is a rare disease with high recurrence and mortality rates. Objective. This study was aimed to evaluate the diagnostic accuracy of echocardiography versus cross-sectional modalities. Material and methods. Our study includes 11 consecutive patients who underwent a comprehensive PV anatomy assessment between April 2018 and June 2019 at Ukrainian Children’s Cardiac Center, Kyiv. Echocardiographic studies of each pulmonary vein followed by computed tomography (CT) or magnetic resonance imaging (MRI) were performed in all patients. A total of 27 CT/MRI studies were performed. Results. There were four patients whose echocardiography findings were completely confirmed by CT/MRI method. In some patients significant stenosis was underestimated by echocardiography. Sensitivity and specificity were 86.4 and 88.9 for echo, as well as 100 and 94.4 for CT/MRI, respectively. Conclusion. This study recognizes the limitations of echocardiography as an imaging tool for pulmonary veins morphology assessment. Cross-sectional studies overcome these limitations and provide excellent morphological as well as functional (MRI) evaluation of pulmonary veins.

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Section: Methodsmentioning

confidence: 99%

Comparison of Echocardiography and Computed Tomography/Magnetic Resonance Imaging for Assessing of Pulmonary Vein Stenosis in Children

Mykychak¹,

Kozhokar²,

Yusifli³

et al. 2020

ujcvs

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“…The sutureless technique may be an effective technique even for the primary repair of TAPVC [3]. Kalfa and colleagues [4] presented an analysis of multi-institutional experience of 14 European and North American institutions with postsurgical pulmonary vein stenosis (PSPVS). They demonstrated that residual severity of the disease is the main prognostic factor for adverse outcomes regardless of the repair method.…”

Section: Fig 1 Selective Pulmonary Vein Angiography and Rpv Balloonmentioning

confidence: 99%

Complex treatment of recurrent pulmonary vein stenosis

Микичак¹

2018

ujcvs

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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.

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“…Peripheral lesions located beyond the first order division within the pulmonary parenchyma are generally beyond the surgeon's reach, rendering the sutureless technique inapplicable in the treatment of distal disease. Further, the results for the sutureless repair with primary PVS and in patients with severe pulmonary vein disease are not as encouraging as with postoperative PVS …”

Section: Introductionmentioning

confidence: 99%

“…Further, the results for the sutureless repair with primary PVS and in patients with severe pulmonary vein disease are not as encouraging as with postoperative PVS. 12 Given the poor prognosis of this disease with the current available technology, our center sought to evaluate the use of drug eluting stents (DES) as a primary mode of therapy for patients with PVS. The purpose of the present study is to review our experience with DES in children with congenital or postoperative PVS after repair of APVR and to compare this modality of treatment with BMS implantation, specifically looking at the incidence of restenosis, reintervention rates, ultimate impact on pulmonary vein patency and patient outcomes.…”

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confidence: 99%

Comparison of drug eluting versus bare metal stents for pulmonary vein stenosis in childhood

Khan

Qureshi

Justino

2019

Cathet Cardio Intervent

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Objective Comparison of outcomes using bare metal (BMS) and drug‐eluting (DES) stents in pulmonary vein stenosis (PVS). Background PVS is a serious condition with frequent restenosis after surgical and percutaneous interventions. After experiencing encouraging results with DES, we sought to compare outcomes of BMS and DES in native and post‐surgical PVS. Methods and Results A retrospective review of all patients who underwent stent implantation between 08/93 and 11/17 for PVS at Texas Children's Hospital was performed. BMS were used to treat 58 lesions in 37 patients and 105 DES used to treat 105 lesions in 41 patients. Mean age at first stent implant was 2.9 ± 3.5 years in BMS and 16.2 ± 18.8 months in DES group. Of those with follow‐up catheterization, mean lumen loss rate from stent implant to first follow‐up catheterization was 0.85 ± 1.47 mm/month over 6.4 ± 6.4 months in the BMS group (n = 44 lesions) compared to 0.16 ± 0.31 mm/month over 6.8 ± 7.4 months in the DES group (n = 86 lesions), p < .01. Follow‐up for the BMS group was 14 months (6 days–22.3 years), with 13 mortalities, eight lesions were re‐stented and six complete occlusions were noted. Follow‐up for DES group (including four cross‐overs) was 17.5 months (3 days‐9 years), with 10 mortalities, seven lesions were re‐stented, 11 had complete occlusion, 20 new adjacent lesions in the same vessel underwent stenting and 12 stents were intentionally fractured. Conclusion DES have significantly lowered lumen loss rate when compared to BMS at medium term follow‐up and can be fractured to enable larger diameters. Availability of larger diameter DES would be ideal.

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Outcomes and prognostic factors for postsurgical pulmonary vein stenosis in the current era

Cited by 55 publications

References 26 publications

Comparison of Echocardiography and Computed Tomography/Magnetic Resonance Imaging for Assessing of Pulmonary Vein Stenosis in Children

Comparison of Echocardiography and Computed Tomography/Magnetic Resonance Imaging for Assessing of Pulmonary Vein Stenosis in Children

Complex treatment of recurrent pulmonary vein stenosis

Comparison of drug eluting versus bare metal stents for pulmonary vein stenosis in childhood

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