Percutaneous pulmonary vein stenting for the treatment of severe stenosis after pulmonary vein isolation.
BACKGROUND
Pulmonary vein stenosis (PVS) is a potential complication of pulmonary vein isolation (PVI) using radiofrequency energy. The aim of our study was the evaluation of the severity and long-term outcome of primary angioplasty and angioplasty with pulmonary vein stenting for PVS.


RESULTS
Twelve patients with 15 PVS (greater than 70% stenosis) were prospectively evaluated. Primary dilation of the stenosis was performed because of clinical symptoms (10 patients) and/or the lung perfusion scans showed a significant perfusion defect (11 patients). Magnetic resonance imaging and lung perfusion scans performed before, directly after, during 3-month, and 6-month follow-up. In the stenting group additional multislice CT-scans directly after, during 6-month, and 12-month follow-up were performed. Within 2 months after primary balloon angioplasty, the PV size parameters were significantly reduced (P < 0.001) with recurrence of PVS in 11 of 15 PVs (73%). Pulmonary vein stenting in 8 patients and 11 PVs resulted in no vein stenosis during 12-month follow-up. Normalization of lung perfusion was noted in 8 of 12 patients. We observed 2 patients with hemoptysis during PV dilation, as severe complications with potential life-threatening character.


CONCLUSIONS
PVS stenting seems to be superior to balloon angioplasty and effective at least over a period of 12 months in treating acquired PVS after pulmonary vein isolation.
Neumann
Thomas
T
Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. TNeuman1@aol.com
Sperzel
Johannes
J
Dill
Thorsten
T
Kluge
Alexander
A
Erdogan
Ali
A
Greis
Harald
H
Hansel
Jochen
J
Berkowitsch
Alexander
A
Kurzidim
Klaus
K
Kuniss
Malte
M
Hamm
Christian W
CW
Pitschner
Heinz-F
HF
D000800:Angioplasty, Balloon; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000473:pathology* / Q000601:surgery; D011668:Pulmonary Veno-Occlusive Disease / Q000209:etiology / Q000601:surgery*; D018709:Statistics, Nonparametric; D015607:Stents; D014057:Tomography, X-Ray Computed