Persistent Oxygen Requirement beyond Prematurity: A Case of Acquired Pulmonary Vein Stenosis

Fick, Tyler A.; Richards, Bernadette; Backes, Carl H.; Ball, Molly K.

doi:10.1155/2017/3106871

Cited by 1 publication

(1 citation statement)

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“…A meta-analysis of infants with primary PVS reported that the majority of infants with PVS had left-to-right shunts [ 4 ], indicating elevated flow through the pulmonary veins, and higher shunt exposure time is associated with the development of PVS in infants with Down’s syndrome [ 5 ]. High flow may also be associated with anemia or infection, and PVS is known to be associated with necrotizing enterocolitis [ 6 ] and other conditions related to prematurity [ 7 , 8 ]. Abnormal pulmonary venous flow can also arise at discrete sites where a vein is compressed, folded, or otherwise partially obstructed, and cardiologists and surgeons at our institution have observed that the initial site of stenosis is often associated with these areas of disturbed blood flow.…”

Section: Introductionmentioning

confidence: 99%

The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case Studies

et al. 2021

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Pulmonary vein stenosis is a serious condition characterized by restriction or blockage due to fibrotic tissue ingrowth that develops in the pulmonary veins of infants or children. It is often progressive and can lead to severe pulmonary hypertension and death. Efforts to halt or reverse disease progression include surgery and catheter-based balloon dilation and stent implantation. Its cause and mechanism of progression are unknown. In this pilot study, we propose and explore the hypothesis that elevated wall shear stress at discrete pulmonary venous sites triggers stenosis. To assess this theory, we retrospectively analyzed cardiac catheterization, lung scan, and X-ray computed tomography data to estimate wall shear stress in the pulmonary veins at multiple time points during disease progression in two patients. Results are consistent with the existence of a level of elevated wall shear stress above which the disease is progressive and below which progression is halted. The analysis also suggests the possibility of predicting the target lumen size necessary in a given vein to reduce wall shear stress to normal levels and remove the trigger for stenosis progression.

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