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Archivos de Bronconeumologia Apr 2022
Topics: Humans; Lung Neoplasms; Neoplasms; Pneumonectomy; Pulmonary Veins; Robotic Surgical Procedures; Thrombosis
PubMed: 35312597
DOI: 10.1016/j.arbres.2021.07.010 -
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 Cardiovascular... Nov 2012Recurrence of atrial fibrillation (AF) after a single ablation procedure has been reported in the range of 15-60% depending on patient selection. A major factor leading... (Review)
Review
Recurrence of atrial fibrillation (AF) after a single ablation procedure has been reported in the range of 15-60% depending on patient selection. A major factor leading to AF recurrence after catheter ablation therapy is electrical reconnection of one or more pulmonary veins (PVs) due to recovery of excitability of atrial tissue within ablation lesions. Maximizing the durability of pulmonary vein isolation (PVI) is critical to reduce recurrence rates and improve outcome after catheter treatment for AF. Strategies to increase the durability of the lesions include optimization of catheter contact by use of steerable sheaths, direct visualization by intracardiac ultrasound, and observation of the decrease in impedance at the beginning of ablation. Furthermore, currently achievable endpoints in addition to electrical PVI may reduce AF recurrence, such as identification of dormant conduction with adenosine administration and rendering the ablation line unexcitable to pacing. Integration of all these strategies into routine catheter ablation procedures for AF has reduced our AF recurrence rates and can easily be incorporated into practice without additional technological advances.
Topics: Atrial Fibrillation; Cardiac Catheters; Catheter Ablation; Echocardiography; Electrophysiologic Techniques, Cardiac; Equipment Design; Humans; Pulmonary Veins; Recurrence; Time Factors; Treatment Outcome
PubMed: 22913515
DOI: 10.1111/j.1540-8167.2012.02414.x -
Archives of Cardiovascular Diseases 2019Pulmonary vein isolation (PVI) using cryoballoon ablation is widely used for rhythm control in patients with paroxysmal atrial fibrillation. This technique has a steep...
BACKGROUND
Pulmonary vein isolation (PVI) using cryoballoon ablation is widely used for rhythm control in patients with paroxysmal atrial fibrillation. This technique has a steep learning curve, and PVI can be achieved quickly in most patients. However, the right inferior pulmonary vein (RIPV) is often challenging to occlude and isolate.
AIM
We aimed to analyse the efficacy of RIPV ablation using a systematic approach.
METHODS
Consecutive patients referred for cryoballoon ablation of paroxysmal atrial fibrillation were enrolled prospectively. A systematic approach was used for RIPV cryoablation. The primary endpoint was acute RIPV isolation during initial freeze.
RESULTS
A total of 214 patients were included. RIPV isolation during initial freeze occurred in 179 patients (82.2%). Real-time PVI could be observed in 72 patients (33.6%), whereas cryoballoon stability required pushing the Achieve™ catheter inside the RIPVs in the remaining patients. The rate of unsuccessful or aborted first freeze as a result of insufficient minimal temperature was significantly higher in patients with real-time pulmonary vein potential recording (16.7% vs. 6.3%; P=0.031). To overcome this issue and obtain both stability and real-time PVI, a dedicated "whip technique" was developed. Twelve patients (5.6%) required a redo ablation; only two of these had a reconnected RIPV.
CONCLUSIONS
A systematic approach to RIPV cryoablation can lead to a high rate of first freeze application. Operators should not struggle to visualize pulmonary vein potentials before ablation, as this may decrease cryoapplication efficacy. Thus, stability should be preferred over real-time PVI for RIPV ablation. Both stability and real-time PVI can be obtained using a "whip technique".
Topics: Action Potentials; Aged; Atrial Fibrillation; Cryosurgery; Female; Heart Rate; Humans; Male; Middle Aged; Prospective Studies; Pulmonary Veins; Recurrence; Reoperation; Treatment Outcome
PubMed: 31447317
DOI: 10.1016/j.acvd.2019.05.006 -
Pediatric Cardiology Oct 2023The fetal pulmonary circulation represents less than 25% of the fetal cardiac output. In comparison with the pulmonary arteries, studies on pulmonary veins are few and... (Review)
Review
The fetal pulmonary circulation represents less than 25% of the fetal cardiac output. In comparison with the pulmonary arteries, studies on pulmonary veins are few and limited, and many questions remain to be answered. The literature reports that pulmonary veins play an important role in regulating vascular flow, forming an active segment of the pulmonary circulation. The development of more sophisticated ultrasonography technology has allowed the investigation of the extraparenchymal pulmonary veins and their waveform. The recognition of the pulmonary vein anatomy in echocardiography is important for the diagnosis of anomalous pulmonary venous connections, with a significant impact on prognosis. On the other hand, the identification of the normal pulmonary vein waveform seems to be a reliable way to study left heart function, with potential applicability in fetal and maternal pathology. Thus, the goal of this narrative review was to provide a clinically oriented perspective of the available literature on this topic.
Topics: Pregnancy; Female; Humans; Pulmonary Veins; Ultrasonography, Prenatal; Fetus; Echocardiography; Ultrasonography, Doppler
PubMed: 37505268
DOI: 10.1007/s00246-023-03244-4 -
Europace : European Pacing,... May 2021
Topics: Atrial Fibrillation; Catheter Ablation; Humans; Pulmonary Veins
PubMed: 33434278
DOI: 10.1093/europace/euaa352 -
Heart Rhythm Dec 2005
Topics: Animals; Atrial Fibrillation; Electrophysiology; Membrane Potentials; Myocytes, Cardiac; Pulmonary Veins
PubMed: 16360088
DOI: 10.1016/j.hrthm.2005.10.020 -
Journal of Anatomy Jan 2024The left atrium wall has several origins, including the body, appendage, septum, atrial-ventricular canal, posterior wall, and venous component. Here, we describe the...
The left atrium wall has several origins, including the body, appendage, septum, atrial-ventricular canal, posterior wall, and venous component. Here, we describe the morphogenesis of left atrium based on high-resolution imaging (phase-contrast X-ray computed tomography and magnetic resonance imaging). Twenty-three human embryos and 19 fetuses were selected for this study. Three-dimensional cardiac images were reconstructed, and the pulmonary veins and left atrium, including the left atrial appendage, were evaluated morphologically and quantitatively. The positions of the pericardial reflections were used as landmarks for the border of the pericardial cavity. The common pulmonary vein was observed in three specimens at Carnegie stages 17-18. The pericardium was detected at the four pulmonary veins (left superior, left inferior, right superior, and right inferior pulmonary veins) at one specimen at Carnegie stage 18 and all larger specimens, except the four samples. Our results suggest that the position of the pericardial reflections was determined at two pulmonary veins (right and left pulmonary vein) and four pulmonary veins almost simultaneously when the dorsal mesocardial connection between the embryo and heart regressed. The magnetic resonance images and reconstructed heart cavity images confirmed that the left atrium folds were present at the junction between the body and venous component. Three-dimensional reconstruction showed that the four pulmonary veins entered the dorsal left atrium tangentially from the lateral to the medial direction. More specifically, the right pulmonary veins entered at a greater angle than the left pulmonary veins. The distance between the superior and inferior pulmonary veins was shorter than that between the left and right pulmonary veins. Three-dimensional reconstruction showed that the venous component increased proportionally with growth. No noticeable differences in discrimination between the right and left parts of the venous component emerged, while the junction between the venous component and body gradually became inconspicuous but was still recognizable by the end of the observed early fetal period. The left superior pulmonary vein had the smallest cross-sectional area and most flattened shape, whereas the other three were similar in area and shape. The left atrial appendage had a large volume in the center and extended to the periphery as a lobe-like structure. The left atrial appendage orifice increased in the area and tended to become flatter with growth. The whole left atrium volume^(1/3) increased almost proportionally with growth, parallel to the whole heart volume. This study provided a three-dimensional and quantitative description of the developmental process of the left atrium, comprising the venous component and left atrial appendage formation, from the late embryonic to the early fetal stages.
Topics: Humans; Pulmonary Veins; Atrial Appendage; Heart Atria; Fetus; Morphogenesis
PubMed: 37559438
DOI: 10.1111/joa.13941 -
Asian Cardiovascular & Thoracic Annals Oct 2022Unilateral pulmonary vein atresia is a rare congenital anomaly that may occur in association with other congenital heart diseases. We report a rare case of left-sided...
Unilateral pulmonary vein atresia is a rare congenital anomaly that may occur in association with other congenital heart diseases. We report a rare case of left-sided pulmonary vein atresia in a 2-year-old child who presented with recurrent hemoptysis and was managed surgically with left pneumonectomy.
Topics: Child, Preschool; Heart Defects, Congenital; Humans; Pulmonary Veins; Rare Diseases; Treatment Outcome; Vascular Malformations
PubMed: 35903869
DOI: 10.1177/02184923221115972 -
Current Medical Imaging 2023Anomalous pulmonary venous connection is a rare congenital variant of the pulmonary veins drained into the right atrium. The left-side partial anomalous pulmonary...
INTRODUCTION
Anomalous pulmonary venous connection is a rare congenital variant of the pulmonary veins drained into the right atrium. The left-side partial anomalous pulmonary connections are usually detected in adulthood and occasionally drain into the left brachiocephalic vein.
CASE DESCRIPTION
An asymptomatic 63-year-old woman with a known history of left carotid body paraganglioma was admitted to our institution to evaluate this tumor by computed tomography angiography of the neck and brain. As an incidental finding, CTA demonstrated a supracardiac partial anomalous pulmonary venous connection between the left upper pulmonary vein and the left innominate via the vertical vein. Additionally, dilation of the azygos vein was observed.
CONCLUSION
Supracardiac left-sided partial anomalous pulmonary venous connection is a rare vascular variant, usually asymptomatic and found incidentally in adults.
Topics: Adult; Female; Humans; Middle Aged; Azygos Vein; Incidental Findings; Dilatation; Pulmonary Veins; Tomography, X-Ray Computed
PubMed: 35692157
DOI: 10.2174/1573405618666220609193652