Successful Angioplasty and Stent Treatment of Pulmonary Vein Stenosis After Single-lung Transplantation

Zimmermann, G.; Reithmann, Christopher; Strauß, T.; Hatz, R.; Brenner, Paolo; Überfuhr, Alois; Frey, Lorenz; Nikolaou, Konstantin; Behr, Jüergen

doi:10.1016/j.healun.2008.11.001

Cited by 11 publications

(12 citation statements)

References 25 publications

(33 reference statements)

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“…[174][175][176][177][178][179][180][181] Emellett létrejöhet tüdővéna-transzpozí-ció sebészi korrekciójának következtében 174,[182][183][184][185][186][187][188][189] vagy tüdő-transzplantáció után is. [190][191][192][193] Felnőtt betegekben a pulmonalis vénák szűkülete kialakulhat a pitvarfibrilláció miatt végzett rá-diófrekvenciás ablatiót követően is. [194][195][196][197][198][199][200][201][202][203][204][205][206][207][208][209] Ritkább okai közé tartozik a tumorok, sarcoidosis vagy mediastinitis miatti külső kompresszió.…”

Section: Pulmonalis Vénákunclassified

Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Feltes¹,

Bacha

Beekman³

et al. 2011

Circulation

745

571

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Section: Pulmonalis Vénákunclassified

Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Feltes¹,

Bacha

Beekman³

et al. 2011

Circulation

745

571

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“…Similarly, Zimmerman et al report one patient who had an iatrogenic pulmonary vein stricture, following single-lung transplantation [4]. The patient underwent pulmonary vein stenting and remained well at 6-month follow-up.…”

Section: Discussionmentioning

confidence: 86%

“…Recent reviews of the literature support early intervention in patients with pulmonary vein stenosis and support the usage of CT and magnetic resonance imaging in making the diagnosis [4]. Meticulous surgical technique during both the retrieval of the donor lung (ensuring an adequate atrial cuff for anastomosis) and the implantation is essential.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous dilatation of right inferior pulmonary vein stenosis following single-lung transplant

Mydin¹,

Calvert²,

Jenkins³

et al. 2012

Interactive CardioVascular and Thoracic Surgery

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We present a 62-year old male who underwent right single-lung transplantation. An autologous pericardial rim was constructed at implantation, as there was insufficient donor atrial cuff. The patient was discharged home but deteriorated over 12 months resulting in oxygen dependency. Computed tomography scan showed stenosis of the right inferior pulmonary vein. The patient underwent pulmonary vein angioplasty under general anaesthesia in September 2007, which was successful and resulted in significant improvement in clinical status. However, his symptoms recurred 2 months later and a second attempt at angioplasty failed. He died 6 weeks later. Keywords: Vein restenosis • Anastomosis • Lung transplantation CASE REPORTWe present the case of a 62-year old man who underwent right single-lung transplantation for usual interstitial pneumonitis (UIP) on 31 August 2006. The UIP was associated with 'SS' phenotype of alpha-1 antitrypsin deficiency. The patient had both physiological and radiographical findings, consistent with a mixed restrictive and obstructive pattern. His only significant medical history was osteoporosis, secondary to steroid usage.Right single-lung transplantation was performed on cardiopulmonary bypass as the patient had moderate pulmonary hypertension. The donor lung was found to have a deficient left atrial cuff with six small vein orifices and minimal atrial cuff tissue infero-posteriorly. This was repaired using an autologous pericardial patch with 4/0 prolene to create suitable rim for anastomosis to the recipient left atrium. This neo-cuff subsequently formed three quarters of the circumference of the anastomosis with the donor LA forming the other quarter ( Figs. 1 and 2). At the end of the procedure, good drainage was confirmed by transoesophageal echocardiogram (TOE), and the patient came off bypass easily with good gas exchange.Early postoperative recovery was uncomplicated. He was started on a calcineurine inhibitor, mycophenolate mofetil and prophylaxis for Pneumocystic Carinii Pneumonia (PCP)/cytomegalovirus (CMV). Over the following 12 months, the patient's respiratory function deteriorated and he became bed-bound and oxygen dependent. He was treated for CMV pneumonitis and aspergillosis. Computed tomography (CT) scanning demonstrated a stenosis at the level of the right inferior pulmonary vein (RIPV) where the vessel measured 2 mm in diameter. The CT scan also demonstrated areas of pulmonary venous infarction upstream of the stenosis. In view of his clinical state, he was considered to be too high risk for surgical intervention.It was, therefore, decided to attempt percutaneous dilatation of the stenosed RIPV. This was performed under general anaesthesia (GA) with TOE and fluoroscopic guidance. Access was gained to the right atrium via the right femoral vein and transseptal puncture was performed with a Brockenbrough Needle (Medtronic, MA) and a 9F-Preface sheath (Biosense Webster, CA). Access to the RIPV from the trans-septal puncture was difficult and, ultimately, the RIPV was ...

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“…5 Prolonged or particularly voluminous chest drain effluent should prompt an evaluation for other associated pathologic conditions, such as a thoracic duct leak (typically obvious from the character of the fluid), or pulmonary vein stenosis (typically associated with a more broadly abnormal clinical picture, such as new or worsened dyspnea, cough, or hemoptysis). 16 Recurrent pleural effusions (those that develop after the removal of the pleural drains) can be more problematic because the associated atelectasis may compromise function of the allograft, lead to pneumonias in hypoventilated lung, become secondarily infected, or develop into chronic pleural space complications (ie, trapped lung).…”

Section: Recurrent Pleural Effusionsmentioning

confidence: 99%

Pleural Space Complications Associated with Lung Transplantation

Arndt

Boffa

2015

Thoracic Surgery Clinics

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Successful Angioplasty and Stent Treatment of Pulmonary Vein Stenosis After Single-lung Transplantation

Cited by 11 publications

References 25 publications

Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Percutaneous dilatation of right inferior pulmonary vein stenosis following single-lung transplant

Pleural Space Complications Associated with Lung Transplantation

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