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Heart Rhythm 2010
Topics: Angioplasty, Balloon; Catheter Ablation; Cryosurgery; Humans; Pulmonary Veins; Recurrence; Reoperation
PubMed: 20129296
DOI: 10.1016/j.hrthm.2009.11.021 -
Journal of Cardiovascular... Sep 2020
Topics: Atrial Fibrillation; Catheter Ablation; Heart Atria; Humans; Pulmonary Veins
PubMed: 32627285
DOI: 10.1111/jce.14653 -
Journal of Cardiovascular... Apr 2003
Topics: Angiography; Atrial Fibrillation; Catheter Ablation; Humans; Postoperative Complications; Pulmonary Veins; Pulmonary Veno-Occlusive Disease
PubMed: 12741707
DOI: 10.1046/j.1540-8167.2003.03043.x -
Orvosi Hetilap Jan 2023Left common pulmonary vein is the most common anatomical variant of pulmonary veins that may affect the outcome of pulmonary vein isolation.
INTRODUCTION
Left common pulmonary vein is the most common anatomical variant of pulmonary veins that may affect the outcome of pulmonary vein isolation.
OBJECTIVE
Our aim was to compare procedural data and outcomes in patients with common trunk versus normal left atrial anatomy for radiofrequency and cryoballoon catheter ablation.
METHOD
Data from patients who underwent pulmonary vein isolation for atrial fibrillation and had a preprocedural cardiac CT scan at our Institution between 01. 10. 2019 and 10. 03. 2022 were retrospectively evaluated. We defined a common trunk where the left superior and inferior pulmonary vein merged at least 5 mm before the left atrial ostium.
RESULTS
From the study population (n = 210), data from 42 patients with a left common trunk (LCPV group) and 60 patients with normal left atrial anatomy (control group) were examined. No significant differences were found between the common trunk and the control group in terms of demographic data. There was no significant difference between the two groups in procedural data for radiofrequency and cryoballoon ablation (procedure time, fluoroscopy time, left atrial dwelling time, radiation dose). After radiofrequency ablation, the success rate at 1-year follow-up was 72.0% in the common trunk group and 76.2% in the control group (p = 0.659). For cryoballoon ablation, the success rate was 64.7% and 69.2% for common trunk and normal anatomy, respectively (p = 0.641).
CONCLUSION
There was no significant difference in the procedural parameters and clinical outcome between patients with left common pulmonary vein and those with normal left atrial anatomy. Both radiofrequency and cryoballoon ablation techniques are well suited for this population. Orv Hetil. 2023; 164(4): 140-147.
Topics: Humans; Atrial Fibrillation; Pulmonary Veins; Prognosis; Treatment Outcome; Retrospective Studies; Cryosurgery; Catheter Ablation; Recurrence
PubMed: 36709438
DOI: 10.1556/650.2023.32678 -
Journal of Medical Case Reports Jun 2023Congenital unilateral pulmonary vein atresia is a rare anomaly resulting from failure of the pulmonary vein to incorporate in the left atrium. It is a very rare cause of...
BACKGROUND
Congenital unilateral pulmonary vein atresia is a rare anomaly resulting from failure of the pulmonary vein to incorporate in the left atrium. It is a very rare cause of recurrent respiratory infections and hemoptysis requiring a high index of suspicion for proper diagnosis and management in early childhood.
CASE PRESENTATION
We report a 13-year old Anuac (Ethiopia, Region of Gambela) male adolescent with a delayed diagnosis of isolated atresia of the left pulmonary veins despite early childhood presentation with recurrent chest infections, hemoptysis and exercise intolerance. Contrast enhanced CT of thorax with reconstructed planes confirmed the diagnosis. He underwent pneumonectomy for severe and recurrent symptoms and did well on subsequent follow ups after 6 months of pneumonectomy.
CONCLUSION
Although a rare anomaly, congenital unilateral pulmonary vein atresia should be considered in the differential diagnosis of a child presenting with recurrent chest infections, exercise intolerance and hemoptysis to facilitate early appropriate diagnosis and treatment.
Topics: Child; Humans; Male; Child, Preschool; Adolescent; Pulmonary Veins; Hemoptysis; Vascular Malformations; Heart Defects, Congenital; Varicose Veins
PubMed: 37269023
DOI: 10.1186/s13256-023-03956-4 -
Journal of the American College of... Jul 1993We investigated whether mortality in totally anomalous pulmonary venous connection could be predicted from preoperative individual pulmonary vein size.
OBJECTIVES
We investigated whether mortality in totally anomalous pulmonary venous connection could be predicted from preoperative individual pulmonary vein size.
BACKGROUND
Some infants with this anomaly die with or without surgical repair because of stenosis of individual pulmonary veins.
METHODS
Individual pulmonary vein, vertical vein and pulmonary venous confluence diameters were retrospectively measured from preoperative echocardiograms in 32 infants with totally anomalous pulmonary venous connection presenting to Children's Hospital, Boston over a 4 1/2-year period. Data on body surface area, other cardiac anomalies, presence of initial pulmonary venous obstruction and early surgery and outcome were also recorded.
RESULTS
Of 32 patients, 6 (18.8%) died before hospital discharge, and 8 (25.0%) died subsequently. Six (75.0%) of the eight patients who died late had individual pulmonary vein stenosis at sites remote from the surgical anastomosis to the left atrium. The remaining 18 patients (56.3%) are alive at a mean follow-up period of 9.7 months. A Cox proportional hazards model revealed that small sum of individual pulmonary vein diameters (p = 0.0004), small confluence size (p = 0.02) and presence of heterotaxy syndrome (p = 0.008) were each significant univariate predictors of survival. Multivariate analysis showed that small pulmonary vein sum was a strong predictor of survival (p = 0.008), independent of the presence of heterotaxy syndrome. An analysis stratified by the presence of heterotaxy syndrome showed that the predictive effect of small pulmonary vein sum on survival was strongest in patients without heterotaxy syndrome.
CONCLUSIONS
These data show that individual pulmonary vein size at diagnosis is a strong, independent predictor of survival in patients with totally anomalous pulmonary venous connection. In patients with this anomaly and small individual pulmonary veins, the anomaly may not be correctable by surgical creation of an anastomosis between the pulmonary venous confluence and the left atrium.
Topics: Echocardiography; Follow-Up Studies; Heart Defects, Congenital; Hospital Mortality; Humans; Infant; Infant, Newborn; Multivariate Analysis; Prognosis; Proportional Hazards Models; Pulmonary Veins; Survival Rate
PubMed: 8509542
DOI: 10.1016/0735-1097(93)90835-o -
JACC. Cardiovascular Interventions Nov 2022
Topics: Humans; Pulmonary Veins; Treatment Outcome; Pulmonary Veno-Occlusive Disease; Angioplasty, Balloon; Ultrasonography, Interventional; Stents
PubMed: 36357037
DOI: 10.1016/j.jcin.2022.08.025 -
The Journal of Thoracic and... Aug 2011Primary pulmonary vein stenosis is often associated with relentless restenosis and early death. During the last 2 decades, we have developed a sutureless repair to...
BACKGROUND
Primary pulmonary vein stenosis is often associated with relentless restenosis and early death. During the last 2 decades, we have developed a sutureless repair to improve prognosis.
METHODS
Hospital records for patients undergoing repair of primary pulmonary vein stenosis from 1989 to 2008 were reviewed. Pulmonary vein stenosis was quantified with a pulmonary vein stenosis score. Survival was determined by Kaplan-Meier analysis.
RESULTS
Twenty-three patients underwent surgical repair. Mean ages at diagnosis and index repair were 23.3 ± 45.6 and 24.1 ± 40.9 months, respectively. Systemic or suprasystemic pulmonary artery pressures were present in 13 of 18 patients (72%). Seven (31%) had single-ventricle circulation. A sutureless technique was used in 19 of 23 cases (83%). Other types of repair were used in 4 of 23 (17%). There were 11 recorded deaths (47%). Survivals were 64%, 47%, and 31% at 1, 5, and 10 years, respectively. Five patients (22%) required 1 reintervention. Surgical repair significantly reduced the total pulmonary vein stenosis score (5.6 ± 2.10 before repair, 2.6 ± 2.72 after repair, P = .0057). The preoperative pulmonary vein stenosis score was the only independent predictor of mortality (hazard ratio, 1.732; P < .01). A preoperative pulmonary vein stenosis score of greater than 4 was a poor prognostic indicator (area under the curve, 0.83).
CONCLUSIONS
Mortality and restenosis rates remained high despite the adoption of a sutureless technique. A preoperative pulmonary vein stenosis score of greater than 4 was a strong predictor of poor prognosis.
Topics: Cardiovascular Surgical Procedures; Child; Child, Preschool; Female; Humans; Infant; Male; Pulmonary Veins; Treatment Outcome
PubMed: 21281946
DOI: 10.1016/j.jtcvs.2010.12.004 -
Cardiovascular Research Dec 2004The perception of atrial fibrillation development has changed drastically over the last decade. The pulmonary veins have been targeted as the source of arrhythmogenic... (Review)
Review
The perception of atrial fibrillation development has changed drastically over the last decade. The pulmonary veins have been targeted as the source of arrhythmogenic activity involved in the initiation of atrial fibrillation. This activity appears to be localized in the myocardial sleeves of the vessels. Extensive study of cells within this tissue has helped create a new model for atrial fibrillation. This review attempts to show how the development, architecture and electrophysiologic properties of the pulmonary veins influence the initiation and perpetuation of atrial fibrillation. It also examines the potential long-term effects of pulmonary vein activity on arrhythmia development.
Topics: Atrial Fibrillation; Chronic Disease; Electrophysiology; Heart Conduction System; Humans; Models, Cardiovascular; Pulmonary Veins
PubMed: 15537491
DOI: 10.1016/j.cardiores.2004.07.025 -
Radiographics : a Review Publication of... 2017The pulmonary veins carry oxygenated blood from the lungs to the heart, but their importance to the radiologist extends far beyond this seemingly straightforward... (Review)
Review
The pulmonary veins carry oxygenated blood from the lungs to the heart, but their importance to the radiologist extends far beyond this seemingly straightforward function. The anatomy of the pulmonary veins is variable among patients, with several noteworthy variant and anomalous patterns, including supernumerary pulmonary veins, a common ostium, anomalous pulmonary venous return, and levoatriocardinal veins. Differences in pulmonary vein anatomy and the presence of variant or anomalous anatomy can be of critical importance, especially for preoperative planning of pulmonary and cardiac surgery. The enhancement or lack of enhancement of the pulmonary veins can be a clue to clinically important disease, and the relationship of masses to the pulmonary veins can herald cardiac invasion. The pulmonary veins are also an integral part of thoracic interventions, including lung transplantation, pneumonectomy, and radiofrequency ablation for atrial fibrillation. This fact creates a requirement for radiologists to have knowledge of the pre- and postoperative imaging appearances of the pulmonary veins. Many of these procedures are associated with important potential complications involving the pulmonary veins, for which diagnostic imaging plays a critical role. A thorough knowledge of the pulmonary veins and a proper radiologic approach to their evaluation is critical for the busy radiologist who must incorporate the pulmonary veins into a routine "search pattern" at computed tomography (CT) and magnetic resonance imaging. This article is a comprehensive CT-based imaging review of the pulmonary veins, including their embryology, anatomy (typical and anomalous), surgical implications, pulmonary vein thrombosis, pulmonary vein stenosis, pulmonary vein pseudostenosis, and the relationship of tumors to the pulmonary veins. Online supplemental material is available for this article. RSNA, 2017.
Topics: Anatomic Variation; Contrast Media; Humans; Patient Care Planning; Preoperative Care; Pulmonary Veins; Tomography, X-Ray Computed
PubMed: 29131765
DOI: 10.1148/rg.2017170050