Pulmonary Vein Stenosis After Lung Transplantation Successfully Treated With Stent Implantation

Pazos-López, Pablo; Piñeiro-Portela, Miriam; Bouzas‐Mosquera, Alberto; Peteiro-Vázquez, Jesús; Vázquez-González, Nicolás; Rueda-Núñez, Fernando; Duro-Tacón, José; Fernandez-Prado, Ricardo; Martínez-Sapiña, M.J.; Castro‐Beiras, Alfonso

doi:10.1161/circulationaha.110.973370

Cited by 12 publications

(8 citation statements)

References 2 publications

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“…Stents have been used for pulmonary venous stenoses with varying success, but it should be emphasized that we implanted bare metal stents in anatomically normal pulmonary veins (opposed to stenotic veins) with relief of obstruction caused by external compression . It is of particular interest that computer tomography showed the pulmonary veins compressed between intrathoroacic structures and the descending aorta in the two patients—a finding that had been described almost a decade ago .…”

Section: Discussionmentioning

confidence: 78%

Delivering stents in congenital heart disease using the double‐wire technique: Technical considerations

Brown

Cools²,

Boshoff³

et al. 2013

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 78%

Delivering stents in congenital heart disease using the double‐wire technique: Technical considerations

Brown

Cools²,

Boshoff³

et al. 2013

Cathet Cardio Intervent

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“…There has been a total of 16 publications following 18 cases of PVS. This includes 10 case reports (3,5,(7)(8)(9)(10)(11)(12)(13)(14) and 6 retrospective studies (15)(16)(17)(18)(19)(20). These studies are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…Comparing the perioperative mortality rate of untreated PVS patients (1 of 2 patients, 50%) (9,17) with treated patients (2 of 17 patients, 11.8%) (3,5,7,8,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), it is suggested that the risk of patient mortality may be decreased by timely diagnosis and appropriate intervention. Retransplantation or open surgical repair to relieve stenosis increases the patient's risk of death, while stent implantation with or without balloon dilation offers a less invasive treatment and seems to have been performed more in recent years.…”

Section: Discussionmentioning

confidence: 99%

“…Retransplantation or open surgical repair to relieve stenosis increases the patient's risk of death, while stent implantation with or without balloon dilation offers a less invasive treatment and seems to have been performed more in recent years. Data showed that PVS patients who received stent placement with/without balloon dilation showed excellent outcomes (3,5,11,12), while patients with balloon dilation as the only intervention method showed a high recurrence rate (13,14). At present, there is no uniform standard for stent size selection, which is mostly performed by clinicians based on their experience.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary vein stenosis after lung transplantation: a case report and literature review

Lei¹,

Chen²,

Zhai³

et al. 2021

Ann Transl Med

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Pulmonary vein stenosis (PVS) is a rare event following lung transplantation which increases the risk of morbidity and mortality. Early detection and rapid treatment of this condition is crucial for its management. Although several reports on PVS have been published, there is little consensus regarding its diagnosis and the methods of management. Here we present our experience with PVS. A 31-year-old man received a left lung transplant for chronic hypersensitivity pneumonitis. One year after his singlelung transplant, he began to develop persistent progressive hypoxemia. Computed tomography (CT) of the chest showed left pleural effusion and thickening of the interlobular septa. The results of bronchoscopy and transbronchial biopsies excluded the possibility of acute rejection or infection. The pleural effusion was transudative with lymphocyte predominance. Computed tomography angiography (CTA) in the left atrium and pulmonary veins demonstrated obvious stenosis of both the upper and lower left pulmonary veins (LLPVs) at the transplant anastomotic site. The patient underwent a catheter-guide stent implantation into the stenotic segment of the upper left pulmonary vein (ULPV), and his pleural effusion and hypoxemia problems were ameliorated. Ten months after the intervention, the patient was in excellent clinical condition.In a literature review, we discuss the importance of identifying PVS early after transplantation, the utility of CTA for diagnosis and the use of pulmonary vein stenting intervention. This review provides a basis for further diagnostic strategies and treatments for PVS following lung transplantation.

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“…Loyalka et al confirmed benefit from the use of IVUS in the management of a case of lower left PVS which was treated with percutaneous stenting [ 4 ]. Another imaging modality that has been shown to be useful, is TEE, both in the diagnosis of PVS and for visual guidance during angiography and stent placement [ 12 ].With the technique of TEE, peak echo gradients can be monitored to ensure successful stent placement and postoperative vein patency. In this case, we used intracardiac echocardiography, which was helpful for trans-septal puncture and stent placement and allowed for the procedure to be completed with conscious sedation.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Vein Stenosis Following Single-Lung Transplantation Successfully Treated with Intravascular Ultrasound-Guided Angioplasty and Stent Placement

et al. 2017

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Patient: Female, 60Final Diagnosis: Pulmonary vein stenosis following single lung transplantSymptoms: Dyspnea on exertion and dry coughMedication: —Clinical Procedure: Balloon angioplasty and stenting of the left common pulmonary veinSpecialty: CardiologyObjective:Unusual clinical courseBackground:Pulmonary vein stenosis (PVS) is a rare event following lung transplantation, but is a serious complication that requires prompt diagnosis and treatment.Case Report:We describe the case of a 60-year-old woman who underwent single-lung transplantation for idiopathic pulmonary fibrosis (IPF). One year following her single-lung transplant, she was admitted to the hospital for hypoxemic respiratory failure. The results of quantitative lung perfusion scintigraphy (LPS) raised the possibility of a diagnosis of PVS. Computed tomography angiography (CT angiography) of the chest identified more than 50% stenosis of the left common pulmonary vein at the anastomotic site with the left atrium. She was successfully treated with angioplasty and stent placement guided by intravascular ultrasonography. Post dilatation of the PVS, the pulmonary venous pressure gradient decreased from 12–16 mm Hg to 3–4 mm Hg. At three-month follow-up, the patient reported resolution of her shortness of breath. In support of this case report, we review the management of four previously reported cases from the literature of lung transplantation associated with PVS.Conclusions:PVS should be considered in the differential diagnosis of lung transplant patients who present with worsening dyspnea. Quantitative LPS and CT angiography are important in the diagnosis of PVS. Successful management of PVS, with salvage of the transplanted lung and the prevention of further surgical interventions, may be achieved with intravascular ultrasound-guided angioplasty and stent placement.

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Pulmonary Vein Stenosis After Lung Transplantation Successfully Treated With Stent Implantation

Cited by 12 publications

References 2 publications

Delivering stents in congenital heart disease using the double‐wire technique: Technical considerations

Delivering stents in congenital heart disease using the double‐wire technique: Technical considerations

Pulmonary vein stenosis after lung transplantation: a case report and literature review

Pulmonary Vein Stenosis Following Single-Lung Transplantation Successfully Treated with Intravascular Ultrasound-Guided Angioplasty and Stent Placement

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