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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 -
The International Journal of... Aug 2019Pulmonary arteriovenous malformation, a condition most commonly associated with hereditary hemorrhagic telangiectasia, is an abnormal communication between the pulmonary... (Review)
Review
Pulmonary arteriovenous malformation, a condition most commonly associated with hereditary hemorrhagic telangiectasia, is an abnormal communication between the pulmonary artery and pulmonary vein without an intervening capillary communication. Although asymptomatic in ~ 50% individuals, it can present with the dreaded complications of stroke or intracranial abscess in high-risk individuals including pregnant women, if untreated. The mainstay of treatment is now endovascular embolization of the feeding artery which can alleviate the symptoms and prevent these complications. In this review, we describe the pathophysiology, methods of screening, diagnostic workup and treatment of these vascular lesions with a particular focus on the currently used embolization techniques and their outcomes.
Topics: Arteriovenous Malformations; Embolization, Therapeutic; Hemodynamics; Humans; Pulmonary Artery; Pulmonary Circulation; Pulmonary Veins; Risk Factors; Treatment Outcome
PubMed: 30386957
DOI: 10.1007/s10554-018-1479-x -
JACC. Cardiovascular Interventions Nov 2023Superior sinus venosus defect is a communication between the right and left atrium located above the upper margin of the oval fossa, immediately inferior to the junction... (Review)
Review
Superior sinus venosus defect is a communication between the right and left atrium located above the upper margin of the oval fossa, immediately inferior to the junction of the superior vena cava and the right atrium. It is systematically associated with partial anomalous pulmonary venous drainage, especially of the right upper pulmonary vein. Surgical repair has been the gold standard approach to close that defect. Introduced in 2014, percutaneous closure has gradually become a safe and effective alternative to surgery in carefully selected patients, although worldwide experience remains limited. This article provides an appraisal of the patients' selection process and a step-by-step description of the procedure as well as a comprehensive review of its outcomes.
Topics: Humans; Vena Cava, Superior; Treatment Outcome; Heart Septal Defects, Atrial; Pulmonary Veins
PubMed: 37855807
DOI: 10.1016/j.jcin.2023.07.024 -
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 -
Journal of Cardiac Surgery Nov 2022With the advent of computed tomographic interrogation, it is increasingly frequent to find venous channels that provide direct connections between the pulmonary and... (Review)
Review
With the advent of computed tomographic interrogation, it is increasingly frequent to find venous channels that provide direct connections between the pulmonary and systemic veins. These channels, before the introduction of three-dimensional techniques for clinical imaging, were usually found providing an "overflow" for the obstructed left atrium in settings such as hypoplastic left heart syndrome, or divided left atrium. Similar channels, however, had been described almost 100 years ago, with one accurately described as a jugulo-pulmonary vein. Nowadays, however, it is much more usual to find the channels described as levoatrial cardinal veins, even though it is recognized that they are not "levo," often not "atrial," and for sure not "cardinal." In this review, we assemble the evidence supporting the notion that they are better considered as pulmonary-to-systemic collateral channels. We emphasize their similarity, in terms of development, to the sinus venosus and coronary sinus defects.
Topics: Heart Atria; Heart Septal Defects, Atrial; Humans; Pulmonary Veins; Vascular Malformations; Vena Cava, Superior
PubMed: 36040644
DOI: 10.1111/jocs.16899 -
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 -
Current Opinion in Cardiology Jan 2021Cryoballoon catheter can create large and contiguous lesions with stable contact during ablation. It has proven to be well tolerated and effective in pulmonary vein... (Review)
Review
PURPOSE OF REVIEW
Cryoballoon catheter can create large and contiguous lesions with stable contact during ablation. It has proven to be well tolerated and effective in pulmonary vein isolation. But atrial arrhythmias, including atrial fibrillation, atrial tachycardia, and atrial flutter (AFL), also relate to many extrapulmonary vein targets. It is necessary to understand the current evidence for the use of cryoballoon ablation for targets outside of pulmonary veins.
RECENT FINDINGS
Studies have shown that the cryoballoon ablation can be used in extrapulmonary vein area, including left atrium roof, left atrial appendages, posterior left atrial wall, mitral isthmus, and right atrial appendage. The results indicate cryoballoon ablation is an effective and well-tolerated treatment option for the atrial arrhythmias in these locations outside of pulmonary vein when clinical necessary.
SUMMARY
The cryoballoon ablation can safely and effectively perform contiguous linear lesions, structure isolations, and local ablation for targets outside of the pulmonary veins.
Topics: Atrial Fibrillation; Catheter Ablation; Cryosurgery; Heart Atria; Humans; Pulmonary Veins; Treatment Outcome
PubMed: 33027099
DOI: 10.1097/HCO.0000000000000802 -
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 -
Circulation Research Jun 2020Atrial fibrillation is the most common sustained cardiac arrhythmia and is associated with considerable morbidity and mortality. Electrically isolating the pulmonary... (Review)
Review
Atrial fibrillation is the most common sustained cardiac arrhythmia and is associated with considerable morbidity and mortality. Electrically isolating the pulmonary veins from the left atrium by catheter ablation is superior to antiarrhythmic drug therapy for maintaining sinus rhythm, but its success varies depending on multiple factors, including arrhythmic burden. Although procedural outcomes have improved over the years, further gains are limited by a seemingly zero-sum relationship between effectiveness and safety, which is largely a product of the available technologies. Current energies used to create contiguous, transmural, and durable atrial lesions can result in serious complications if they reach the esophagus or phrenic nerve, for instance-structures that can be adjacent to the atrial myocardium, often within millimeters of the energy source. Consequently, high rates of pulmonary vein-left atrium reconnections are consistently seen in clinical studies and in clinical practice as operators appropriately forgo ablation effectiveness to protect patients from harm. However, as ablative technologies evolve to circumvent this stalemate, safer, and more effective pulmonary vein isolation seems increasingly realistic. Furthermore, the innovative nature of these technologies raises the prospect of markedly improved procedural efficiency, which could increase patient comfort, reduce operator occupational injuries, and enhance the use of health resources-all of which are increasingly important considerations particularly as the demand for catheter ablation for atrial fibrillation continues to rise. We herein review 3 promising candidate ablation technologies with the potential to revolutionize the management of patients with atrial fibrillation: electroporation (pulsed-field ablation), expandable lattice-tip radiofrequency ablation/electroporation, and ultra-low temperature cryoablation.
Topics: Animals; Atrial Fibrillation; Catheter Ablation; Humans; Pulmonary Veins
PubMed: 32716722
DOI: 10.1161/CIRCRESAHA.120.316402