scholarly journals Modified sutureless repair using left atrial appendage flap for acquired left-sided pulmonary vein stenosis

2020 ◽  
Vol 58 (2) ◽  
pp. 395-397
Author(s):  
Hideki Ito ◽  
Masato Mutsuga ◽  
Yoshiyuki Tokuda ◽  
Akihiko Usui
Keyword(s):  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Left Atrial ◽  
Radiofrequency Catheter Ablation ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Successful Outcome ◽  
Pulmonary Vein Stenosis ◽  
Sutureless Technique ◽  
Vein Stenosis

Abstract Pulmonary vein stenosis is a well-known complication after radiofrequency catheter ablation of atrial fibrillation. Although surgical repair is indicated for younger patients and patients with multiple stenoses, the appropriate procedure for acquired pulmonary vein stenosis has not been established. In this study, we report the successful outcome of our modified sutureless technique using a left atrial appendage flap for left-sided pulmonary vein stenosis after radiofrequency catheter ablation.

Abstract 14990: Pulmonary Vein Stenosis After Epicardial Atrial Fibrillation Ablation and Epicardial Left Atrial Appendage Occlusion: A Diagnostic Dilemma and Challenges in Management

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Moghniuddin Mohammed ◽  
Nachiket Apte ◽  
Mohammed Ansari ◽  
Amit Noheria ◽  
Seth Sheldon ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Maze Procedure ◽  
Pulmonary Vein Stenosis ◽  
Epicardial Ablation ◽  
Left Atrial Appendage Occlusion ◽  
Vein Stenosis

Background: Pulmonary vein stenosis is a dreaded complication of endocardial atrial fibrillation (AF) ablation but rare after epicardial ablation and has not been reported after epicardial left atrial appendage occlusion (LAAO). Case: A 55-year-old male was referred to our tertiary hospital for management of left superior pulmonary vein (LSPV) stenosis causing dyspnea on exertion. About 2 years prior to presentation, he underwent quadruple coronary artery bypass grafting for non-ST elevation myocardial infarction along with modified Cox-Maze procedure with pulmonary vein and posterior wall isolation as well as epicardial LAAO with AtriClip for history of paroxysmal AF. At our institute, V/Q scan showed ventilation-perfusion mismatch and absent perfusion of the left upper lobe (Figure 1A). Cardiac CT showed persistent LSPV occlusion (Figure 1B). TEE showed atrial appendage occluded with a clip and no flow was observed from LSPV (Figure 1C). After multidisciplinary discussion between cardiology and cardiothoracic surgery teams, surgical approach to remove the AtriClip was deemed futile as it was placed 2 years ago and less likely to result in resolution of stenosis. Thus, an endovascular approach was attempted with left atrial and pulmonary vein angiography showing LSPV to be 100% occluded (Figure 1D). Pulmonary vein recanalization was attempted but was not successful. Conclusion: Our case highlights the importance of recognition of PVS as a possible complication after epicardial LAAO as early intervention can improve patient outcomes. PVS has been previously described with Maze procedure but that patient was successfully treated with catheter-balloon angioplasty. Given 100% occlusion and difficulty with recanalization makes epicardial ablation a less likely cause of occlusion in our case. More careful application of Atriclip protocols might be necessary to prevent this potential complication.

scholarly journals Incidence of Pulmonary Vein Stenosis After Radiofrequency Catheter Ablation of Atrial Fibrillation

2017 ◽  
Vol 3 (6) ◽  
pp. 589-598 ◽  
Author(s):  
Cas Teunissen ◽  
Birgitta K. Velthuis ◽  
Rutger J. Hassink ◽  
Jeroen F. van der Heijden ◽  
Evert-Jan P.A. Vonken ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Radiofrequency Catheter Ablation ◽  
Pulmonary Vein Stenosis ◽  
Vein Stenosis
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