Sutureless technique using the left atrial appendage for left pulmonary vein occlusion after catheter ablation

Abstract

Background: Pulmonary vein stenosis or occlusion is a rare but one of the most devastating complications after catheter ablation for cardiac arrhythmias, and surgical repair is an option in severe cases. The sutureless technique, which avoids direct suture of vessel walls, was initially described for congenital pulmonary vein stenosis and has been widely performed due to its good restenosis-free rate. Case presentation: A 52-year-old male developed left pulmonary vein occlusion after catheter ablation for atrial fibrillation. The surgical repair with sutureless technique using the left atrial appendage was performed without any complications. Postoperative computed tomography demonstrated the revascularization of the pulmonary vein. Conclusions: The sutureless technique using the left atrial appendage is significantly reasonable particularly in case of left pulmonary vein stenosis or occlusion after catheter ablation for atrial fibrillation since it reduces the risks of restenosis and thromboembolism.

A modified sutureless repair for left pulmonary vein obstruction after catheter ablation

“…A high rate of restenosis is associated with interventional therapy with or without stent placement for iatrogenic PV stenosis post-catheter ablation procedures (3). Surgical repair represents an alternative option stemming from congenital PV malformation surgery experience, where the sutureless technique is a well-established treatment [ 4–6 ]. This technique has the advantage of being less technique sensitive, including freedom from the requirement for direct anastomoses with the PV and avoidance of geometric distortion of PV structures.…”

“…Percutaneous intervention for PV stenosis is associated with a high incidence of PV restenosis [ 2 , 3 ]. Several surgical approaches have been recently described to treat this pathology [ 4–7 ]. Herein, we report a case of modified surgical repair for complex left PV stenosis and occlusion.…”