Total pulmonary vein occlusion complicating pulmonary vein isolation: Diagnosis and treatment

Prieto, Lourdes; Kawai, Yu; Worley, Sarah

doi:10.1016/j.hrthm.2010.03.003

Cited by 25 publications

(40 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[5][6][7][8] To prevent the development of PV stenosis, extensive PVI was introduced, which brought about improved clinical outcomes. 1,2 Extensive PVI, however, requires long ablation lines, which prolong radiofrequency delivery.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 However, pathology reports after catheter-based PVI are rare, [3][4][5] leaving the histologic process underlying pulmonary vein (PV) reconnection or PV stenosis after ablation therapy unclear. [5][6][7] We report postmortem histologic examination of hearts from 2 patients: one treated by extensive circumferential PVI and the other by ostial PVI.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pathology in the late phase after extensive and ostial pulmonary vein ablation for atrial fibrillation: Findings in 2 postmortem cases

et al. 2015

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pathology in the late phase after extensive and ostial pulmonary vein ablation for atrial fibrillation: Findings in 2 postmortem cases

et al. 2015

View full text Add to dashboard Cite

“…Echocardiography, CCT, CMR or direct invasive angiographic imaging can be employed to define the PV anatomy. [128][129][130][131] Of the non-invasive modalities only TTE and CMR can provide functional information of flow dynamics, although TTE appears to underestimate the severity of stenosis in comparison to CMR. 132 Recanalization with balloon dilatation and stenting is possible when a remnant of the PV remains.…”

Section: Pv Stenosismentioning

confidence: 99%

“…132 Recanalization with balloon dilatation and stenting is possible when a remnant of the PV remains. 130 …”

Section: Pv Stenosismentioning

confidence: 99%

The Role of Left Atrial Imaging in the Management of Atrial Fibrillation

Walters

Ellims

Kalman

2015

Progress in Cardiovascular Diseases

View full text Add to dashboard Cite

“…The diagnosis of pulmonary vein stenosis or occlusion is usually delayed. It is strongly recommended that post-ablation patients be followed up with regular enhanced CT or MRI (4,5). Early diagnosis may provide the opportunity to perform transcatheter balloon angioplasty or stenting, thus obviating the need for surgical intervention.…”

mentioning

confidence: 99%

Thoracoscopic lobectomy for massive hemoptysis caused by complete pulmonary vein occlusion after radiofrequency ablation for atrial fibrillation

Cheng

Wang

et al. 2018

J. Thorac. Dis.

View full text Add to dashboard Cite

Complete pulmonary vein occlusion is a rare complication of transcatheter radiofrequency ablation for atrial fibrillation. We here report a 37-year-old man who presented with massive hemoptysis as a result of left superior pulmonary vein occlusion caused by transcatheter radiofrequency ablation for paroxysmal atrial fibrillation. The patient was successfully managed with thoracoscopic left upper lobectomy with a satisfactory outcome. J Thorac Dis 2018;10(4):E296-E300 jtd.amegroups.com stenosis of the left inferior pulmonary vein ( Figure 3C,D). Bronchoscopy showed hyperemic left main and left upper lobe bronchi and severe dilation of submucosal blood vessels (Figure 4). An echocardiogram showed normal pulmonary arterial pressure. The patient was diagnosed as having massive hemoptysis as a result of left superior pulmonary vein occlusion caused by transcatheter radiofrequency ablation on the basis of these findings.Left upper lobectomy was performed by video-assisted thoracoscopy using two ports: a 10-mm port for the camera in the seventh intercostal space and a 40-mm surgical incision in the fourth intercostal space. The left upper lobe was adherent to the chest wall and the mediastinum ( Figure 5A,B). Neovascularization was visible overlying the left upper lobe, hilum, and descending aorta ( Figure 5A,C,D). The mediastinal pleura were incised in the hilar region. Severe adhesion was noted ( Figure 5E). The left superior pulmonary vein was completely obliterated, having been replaced with dense fibrotic tissues. It proved impossible to dissect the left superior pulmonary vein from the left upper lobe bronchus ( Figure 5F) and it was feared that forced isolation might tear the superior pulmonary vein. The proximal branches of the pulmonary artery were difficult to access from the anterior perspective without isolation and division of the superior pulmonary vein. The oblique fissure was therefore dissected to expose the interlobar pulmonary artery and its branches. When they had been identified, the arterial branches to the left upper lobe were divided and the posterior and anterior fissure stapled, leaving the left superior pulmonary vein and left upper lobe bronchus. Finally, an Endo-GIA 45 purple Tri-stapler (Medtronic, Minneapolis, MN, USA) was used to staple both the bronchus and obliterated pulmonary vein. The surgery was successful with intraoperative bleeding of 150 mL and the postoperative course was uneventful, with no complications such as recurrence of hemoptysis or development of a bronchopleural fistula. The patient spent two days in ICU. The chest tube was removed on postoperative Day 5, the daily drainage having been 200 mL, and was discharged on postoperative Day 8 with a normal chest radiograph. Outpatient clinic follow-up was arranged at 2 weeks, 3 months and 6 months after discharge. The patient remained free of symptoms, such as hemoptysis or dyspnea, and recovered well.Histologic examination of hematoxylin and eosin stainedsections demonstrated thrombosis and obliteration of the ...

show abstract

Total pulmonary vein occlusion complicating pulmonary vein isolation: Diagnosis and treatment

Cited by 25 publications

References 11 publications

Pathology in the late phase after extensive and ostial pulmonary vein ablation for atrial fibrillation: Findings in 2 postmortem cases

Pathology in the late phase after extensive and ostial pulmonary vein ablation for atrial fibrillation: Findings in 2 postmortem cases

The Role of Left Atrial Imaging in the Management of Atrial Fibrillation

Thoracoscopic lobectomy for massive hemoptysis caused by complete pulmonary vein occlusion after radiofrequency ablation for atrial fibrillation

Contact Info

Product

Resources

About