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The Journal of Thoracic and... Jun 2021
Topics: Child; Child, Preschool; Heart Defects, Congenital; Humans; Infant; Lung Transplantation; Pulmonary Veins; Stenosis, Pulmonary Vein
PubMed: 32763037
DOI: 10.1016/j.jtcvs.2020.05.117 -
JACC. Clinical Electrophysiology Jul 2019
Topics: Atrial Fibrillation; Catheter Ablation; Humans; Pulmonary Veins; Temperature; Time Factors
PubMed: 31320007
DOI: 10.1016/j.jacep.2019.05.007 -
Interventional Cardiology Clinics Jul 2024Pulmonary vein stenosis (PVS) is a rare and unique disease of infants and young children. PVS is attended by high morbidity and mortality, and for many decades,... (Review)
Review
Pulmonary vein stenosis (PVS) is a rare and unique disease of infants and young children. PVS is attended by high morbidity and mortality, and for many decades, effective therapy eluded the practitioner. However, in the most recent era, interventional techniques when employed in combination with systemic (primary) therapy have had a remarkable impact on outcomes in these at-risk children. Despite apparent complete relief of PVS in a discrete region of a pulmonary vein, stenosis reliably recurs and progresses. In this review, we discuss the current state-of-the-art interventional techniques, through the lens of our collective experiences and practices.
Topics: Humans; Stenosis, Pulmonary Vein; Pulmonary Veins; Stents; Infant
PubMed: 38839175
DOI: 10.1016/j.iccl.2024.03.003 -
Journal of Cardiovascular... Aug 2020Over the past 20 years, multiple studies have demonstrated the superiority of percutaneous catheter-based pulmonary vein isolation (PVI) in the management of atrial... (Review)
Review
Over the past 20 years, multiple studies have demonstrated the superiority of percutaneous catheter-based pulmonary vein isolation (PVI) in the management of atrial fibrillation (AF). Unfortunately, the results of catheter ablation can be limited by arrhythmia recurrence, which is often a result of a failure to achieve durable lesions around the pulmonary vein ostia. In response, significant efforts have been directed toward developing technologies to achieve safer and more durable PVI, including the development of dedicated catheters capable of achieving PVI with a single ablation lesion (eg, the Arctic Front Cryoballoon; Medtronic CryoCath, Pointe-Claire, Canada). The purpose of this review is to discuss the contemporary role of cryoballoon ablation in the invasive management of AF, with a focus on the characteristics that differentiate cryoballoon from radiofrequency ablation.
Topics: Atrial Fibrillation; Canada; Catheter Ablation; Cryosurgery; Humans; Pulmonary Veins; Recurrence; Time Factors; Treatment Outcome
PubMed: 32239557
DOI: 10.1111/jce.14459 -
Circulation Journal : Official Journal... Nov 2023
Topics: Humans; Stenosis, Pulmonary Vein; Pulmonary Veins; Catheter Ablation; Iatrogenic Disease; Atrial Fibrillation; Treatment Outcome; Angioplasty, Balloon
PubMed: 37380435
DOI: 10.1253/circj.CJ-23-0388 -
Pediatric Pulmonology Mar 2021Pulmonary vein stenosis is a rare and poorly understood condition causing obstruction of the large pulmonary veins and of blood flow from the lungs to the left atrium.... (Review)
Review
Pulmonary vein stenosis is a rare and poorly understood condition causing obstruction of the large pulmonary veins and of blood flow from the lungs to the left atrium. This results in elevated pulmonary venous pressure and pulmonary edema, pulmonary hypertension, potentially cardiac failure, and death. Clinical signs of the disease include failure to thrive, increasingly severe dyspnea, hemoptysis, respiratory difficulty, recurrent respiratory tract infections/pneumonia, cyanosis, and subcostal retractions. On chest radiograph, the most frequent finding is increased interstitial, ground-glass and/or reticular opacity. Transthoracic echocardiography with pulsed Doppler delineates the stenosis, magnetic resonance imaging and multislice computerized tomography are used for further evaluation. Interventional cardiac catherization, surgical techniques, and medical therapies have been used with varying success as treatment options.
Topics: Angioplasty; Cardiac Catheterization; Child; Child, Preschool; Constriction, Pathologic; Echocardiography; Hemodynamics; Hemoptysis; Humans; Infant; Magnetic Resonance Imaging; Pulmonary Veins; Stenosis, Pulmonary Vein; Stents; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 32506838
DOI: 10.1002/ppul.24848 -
Pediatric Cardiology Dec 2023Pulmonary vein stenosis (PVS) in children is a challenging condition with poor outcomes. Post-operative stenosis can occur after repair of anomalous pulmonary venous...
Pulmonary vein stenosis (PVS) in children is a challenging condition with poor outcomes. Post-operative stenosis can occur after repair of anomalous pulmonary venous return (APVR) or stenosis within native veins. There is limited data on the outcomes of post-operative PVS. Our objective was to review our experience and assess surgical and transcatheter outcomes. Single-center retrospective study was performed including patients < 18 years who developed restenosis after baseline pulmonary vein surgery that required additional intervention(s) from 1/2005 to 1/2020. Non-invasive imaging, catheterization and surgical data were reviewed. We identified 46 patients with post-operative PVS with 11 (23.9%) patient deaths. Median age at index procedure was 7.2 months (range 1 month-10 years), and median follow-up was 10.8 months (range 1 day-13 years). Index procedure was surgical in 36 (78.3%) and transcatheter in 10 (21.7%). Twenty-three (50%) patients developed vein atresia. Mortality was not associated with number of affected veins, vein atresia, or procedure type. Single ventricle physiology, complex congenital heart disease (CCHD), and genetic disorders were associated with mortality. Survival rate was higher in APVR patients (p = 0.03). Patients with three or more interventions had a higher survival rate compared to patients with 1-2 interventions (p = 0.02). Male gender, necrotizing enterocolitis, and diffuse hypoplasia were associated with vein atresia. In post-operative PVS, mortality is associated with CCHD, single ventricle physiology, and genetic disorders. Vein atresia is associated with male gender, necrotizing enterocolitis, and diffuse hypoplasia. Multiple repeated interventions may offer a patient survival benefit; however, larger prospective studies are necessary to elucidate this relationship further.
Topics: Child; Humans; Infant, Newborn; Male; Infant; Stenosis, Pulmonary Vein; Constriction, Pathologic; Retrospective Studies; Enterocolitis, Necrotizing; Prospective Studies; Pulmonary Veins; Risk Factors; Scimitar Syndrome; Univentricular Heart; Treatment Outcome
PubMed: 37422845
DOI: 10.1007/s00246-023-03214-w -
The International Journal of... Apr 2021
Topics: Humans; Predictive Value of Tests; Pulmonary Circulation; Pulmonary Embolism; Pulmonary Veins; Venous Thrombosis
PubMed: 33151512
DOI: 10.1007/s10554-020-02096-w -
Circulation. Arrhythmia and... Apr 2018
Topics: Animals; Catheter Ablation; Pulmonary Veins; Swine
PubMed: 29654135
DOI: 10.1161/CIRCEP.118.006378 -
Journal of Cardiovascular... Feb 2022
Topics: Catheter Ablation; Humans; Pulmonary Veins
PubMed: 34910351
DOI: 10.1111/jce.15320