Extensive pulmonary venous stenoses as a complication of radiofrequency catheter ablation for atrial fibrillation
Although pulmonary veins stenosis (PVS) is a well documented complication of radiofrequency-catheter ablation (RFCA) of atrial fibrillation (AF), simultaneous involvement of multiple PVs is extremely rare. We present the case of a 69 years-old male patient, with prior medical history of persistent A...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S193004332200694X |
| _version_ | 1828111556601184256 |
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| author | Juan I. Cotella, MD Lydia Chelala, MD Atman P. Shah, MD Ben Chung, MD Jeremy Slivnick, MD |
| author_facet | Juan I. Cotella, MD Lydia Chelala, MD Atman P. Shah, MD Ben Chung, MD Jeremy Slivnick, MD |
| author_sort | Juan I. Cotella, MD |
| collection | DOAJ |
| description | Although pulmonary veins stenosis (PVS) is a well documented complication of radiofrequency-catheter ablation (RFCA) of atrial fibrillation (AF), simultaneous involvement of multiple PVs is extremely rare. We present the case of a 69 years-old male patient, with prior medical history of persistent AF, who had been treated with RFCA two years ago. After RFCA, he started with shortness of breath and needed hospitalization for bilateral pneumonia. One year after the procedure, he was on home oxygen, but still referred dyspnea, cough and hemoptysis. A transthoracic echocardiogram showed moderate right ventricular (RV) systolic dysfunction and elevated RV systolic pressure. Dedicated cardiac tomography for PV assessment revealed severe narrowing and pre-stenotic engorgement of all 5 PVs, with subtotal ostial occlusion of both the left lower and right middle PVs. PV angiography confirmed the diagnosis. Only the left and right upper PV were able to be wire-crossed and stented, with substantial reductions in stenosis from 90 % to 10 %. After 3 months of follow-up, the patient improved substantially, and home O2 was withdrawn. |
| first_indexed | 2024-04-11T11:37:39Z |
| format | Article |
| id | doaj.art-30fd261f0df545e0981ef8891bca854a |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-04-11T11:37:39Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-30fd261f0df545e0981ef8891bca854a2022-12-22T04:25:55ZengElsevierRadiology Case Reports1930-04332022-11-01171142994301Extensive pulmonary venous stenoses as a complication of radiofrequency catheter ablation for atrial fibrillationJuan I. Cotella, MD0Lydia Chelala, MD1Atman P. Shah, MD2Ben Chung, MD3Jeremy Slivnick, MD4Department of Medicine, Section of Cardiology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 6092, Chicago, IL 60637-1470, USADepartment of Medicine, Section of Cardiology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 6092, Chicago, IL 60637-1470, USADepartment of Medicine, Section of Cardiology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 6092, Chicago, IL 60637-1470, USADepartment of Medicine, Section of Cardiology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 6092, Chicago, IL 60637-1470, USACorresponding author.; Department of Medicine, Section of Cardiology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 6092, Chicago, IL 60637-1470, USAAlthough pulmonary veins stenosis (PVS) is a well documented complication of radiofrequency-catheter ablation (RFCA) of atrial fibrillation (AF), simultaneous involvement of multiple PVs is extremely rare. We present the case of a 69 years-old male patient, with prior medical history of persistent AF, who had been treated with RFCA two years ago. After RFCA, he started with shortness of breath and needed hospitalization for bilateral pneumonia. One year after the procedure, he was on home oxygen, but still referred dyspnea, cough and hemoptysis. A transthoracic echocardiogram showed moderate right ventricular (RV) systolic dysfunction and elevated RV systolic pressure. Dedicated cardiac tomography for PV assessment revealed severe narrowing and pre-stenotic engorgement of all 5 PVs, with subtotal ostial occlusion of both the left lower and right middle PVs. PV angiography confirmed the diagnosis. Only the left and right upper PV were able to be wire-crossed and stented, with substantial reductions in stenosis from 90 % to 10 %. After 3 months of follow-up, the patient improved substantially, and home O2 was withdrawn.http://www.sciencedirect.com/science/article/pii/S193004332200694XComputed tomographyPulmonary veins stenosisAtrial fibrillation |
| spellingShingle | Juan I. Cotella, MD Lydia Chelala, MD Atman P. Shah, MD Ben Chung, MD Jeremy Slivnick, MD Extensive pulmonary venous stenoses as a complication of radiofrequency catheter ablation for atrial fibrillation Radiology Case Reports Computed tomography Pulmonary veins stenosis Atrial fibrillation |
| title | Extensive pulmonary venous stenoses as a complication of radiofrequency catheter ablation for atrial fibrillation |
| title_full | Extensive pulmonary venous stenoses as a complication of radiofrequency catheter ablation for atrial fibrillation |
| title_fullStr | Extensive pulmonary venous stenoses as a complication of radiofrequency catheter ablation for atrial fibrillation |
| title_full_unstemmed | Extensive pulmonary venous stenoses as a complication of radiofrequency catheter ablation for atrial fibrillation |
| title_short | Extensive pulmonary venous stenoses as a complication of radiofrequency catheter ablation for atrial fibrillation |
| title_sort | extensive pulmonary venous stenoses as a complication of radiofrequency catheter ablation for atrial fibrillation |
| topic | Computed tomography Pulmonary veins stenosis Atrial fibrillation |
| url | http://www.sciencedirect.com/science/article/pii/S193004332200694X |
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