-
JACC. Cardiovascular Interventions Mar 2022
Topics: Humans; Mediastinitis; Pulmonary Artery; Pulmonary Veins; Pulmonary Wedge Pressure; Stenosis, Pulmonary Vein; Treatment Outcome
PubMed: 35033473
DOI: 10.1016/j.jcin.2021.11.019 -
Journal of Cardiovascular... Sep 2020
Topics: Atrial Fibrillation; Catheter Ablation; Humans; Long QT Syndrome; Pulmonary Veins
PubMed: 32557959
DOI: 10.1111/jce.14622 -
World Journal of Surgical Oncology May 2022A right top pulmonary vein (RTPV) that crosses behind the right main or intermediate bronchus is a variation of the superior posterior pulmonary vein in the right upper... (Review)
Review
Right top pulmonary vein is a venous anomaly of which surgeons should be aware in subcarinal dissection for thoracoscopic esophagectomy: a case report and literature review.
BACKGROUND
A right top pulmonary vein (RTPV) that crosses behind the right main or intermediate bronchus is a variation of the superior posterior pulmonary vein in the right upper lobe. Damage or ligation of this abnormal vessel can lead to massive intraoperative bleeding and serious complications, such as congestion of the posterior segment of the right upper lobe and cardiac tamponade. Subcarinal lymph node dissection is mandatory in radical thoracoscopic esophagectomy for esophageal cancer, and the RTPV is an anomalous vessel of which thoracic surgeons should be aware.
CASE PRESENTATION
A 70-year-old man underwent thoracoscopic esophagectomy for esophageal cancer (T3N1M0). An anomaly of the superior posterior pulmonary vein in the right lobe was recognized on preoperative computed tomography imaging. With simulation and intraoperative navigation using three-dimensional imaging of the same view as that observed during the operation, radical subcarinal dissection could be performed with preservation of the RTPV.
CONCLUSION
In our review of the relevant literature, the incidence of RTPV ranged from 0.28 to 9.3%, and its mean vascular diameter was 7.0 mm at the maximum and 2.2 ± 0.72 mm at the minimum, with the right superior pulmonary vein being a relatively common inflow site. Our case in which the RTPV ran dorsal to the right main bronchus is very rare. In radical subcarinal dissection of thoracoscopic esophagectomy, it is important to recognize the posterior pericardial plane and release the ventral fixation of these lymph nodes to free space for the back side. This is also true in the case of RTPV, which should be noted to avoid injury. In cases involving an RTPV larger than 4.5 mm, ligation should be avoided, and preoperative recognition of the exact run of this abnormal vessel using three-dimensional imaging can be very useful.
Topics: Aged; Esophageal Neoplasms; Esophagectomy; Humans; Lymph Node Excision; Male; Pulmonary Veins; Surgeons; Vascular Malformations
PubMed: 35590376
DOI: 10.1186/s12957-022-02635-w -
Europace : European Pacing,... Apr 2020
Topics: Catheter Ablation; Cryosurgery; Pulmonary Veins
PubMed: 31793999
DOI: 10.1093/europace/euz326 -
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 -
JACC. Cardiovascular Interventions Jul 2022
Topics: Angioplasty, Balloon; Humans; Mediastinitis; Pulmonary Artery; Pulmonary Veins; Treatment Outcome
PubMed: 35863807
DOI: 10.1016/j.jcin.2022.04.008 -
Journal of Interventional Cardiac... Oct 2023A compressible lattice-tip catheter designed for focal ablation using radiofrequency or pulsed-field energies has been recently described. The objective of this study is... (Review)
Review
BACKGROUND
A compressible lattice-tip catheter designed for focal ablation using radiofrequency or pulsed-field energies has been recently described. The objective of this study is to describe a new lattice catheter designed for single-shot pulmonary vein isolation (PVI).
METHODS
This 8F catheter consists of a compressible lattice tip that is delivered over the wire and is expandable up to 34 mm (SpherePVI™, Affera Inc.). Pulsed field ablation (PFA) was applied from 6 elements using a biphasic waveform of microsecond scale (± 1.3-2.0 kV, 5 s per application). In 12 swine, the superior vena cava (SVC) and right superior pulmonary vein (RSPV) were targeted for isolation. Animals were survived for 12-24 h (n = 6) or 3 weeks (n = 6) for evaluation of short and long-term safety and efficacy parameters. PVI was evaluated immediately after ablation and at the terminal procedure. Ablation-related microbubbles were examined using intracardiac echocardiography and phrenic nerve function by pacing. The tissue was examined by histopathology.
RESULTS
In all 12 animals, PFA resulted in successful acute isolation of the SVC and RSPV using 2.8 ± 1.1 and 3.2 ± 1.2 applications per vein, respectively. After a survival period of 23 ± 5.9 days, all targeted veins remained isolated, and the level of isolation persisted without significant regression or expansion. In one animal, SVC isolation at the level of the right atrial appendage resulted in sinus node arrest. PFA did not affect phrenic nerve function, and it was associated with a few isolated bubbles formation.
CONCLUSIONS
In this pre-clinical study, a new expandable lattice catheter designed for single-shot PVI was able to achieve rapid and durable isolation.
Topics: Swine; Animals; Atrial Fibrillation; Pulmonary Veins; Catheter Ablation; Vena Cava, Superior; Catheters; Treatment Outcome
PubMed: 36441424
DOI: 10.1007/s10840-022-01414-7 -
Journal of Cardiovascular... Jan 2011
Topics: Atrial Fibrillation; Female; Heart Atria; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pulmonary Veins
PubMed: 20840464
DOI: 10.1111/j.1540-8167.2010.01903.x -
Heart, Lung & Circulation Apr 2022
Topics: Atrial Fibrillation; Catheter Ablation; Cryosurgery; Humans; Pulmonary Veins
PubMed: 35153148
DOI: 10.1016/j.hlc.2022.01.004 -
General Thoracic and Cardiovascular... Dec 2021Acquired pulmonary vein (PV) stenosis (PVS) is a complication following cardiac catheter intervention. However, very few cases of PVS after surgical ablation have been...
Acquired pulmonary vein (PV) stenosis (PVS) is a complication following cardiac catheter intervention. However, very few cases of PVS after surgical ablation have been reported. We herein report a case of stenosis and occlusion at the left atrium to each pulmonary vein after surgical ablation. A 73-year-old woman who had received aortic valve replacement and pulmonary vein isolation 10 months earlier was diagnosed with congestive heart failure accompanied by pulmonary hypertension. Contrast-enhanced computed tomography revealed stenosis and complete occlusion of the left atrium to all four pulmonary veins. Surgical repair was performed via pericardial patch reconstruction of the left atrium to each PV. Treating multiple PV lesions with involvement of the left atrium wall requires tailored methods. However, there have been few reports concerning such methods of reconstruction. We herein report a method of reconstructing the left atrium and pulmonary veins at the same time.
Topics: Aged; Atrial Fibrillation; Catheter Ablation; Female; Heart Atria; Humans; Pulmonary Veins; Stenosis, Pulmonary Vein; Treatment Outcome
PubMed: 34514539
DOI: 10.1007/s11748-021-01700-7