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Results for “PULMONARY VEINS”

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At least 37 records · Page 2Linked to original sources
PubMed2003

Effect of heating on pulmonary veins: how to avoid pulmonary vein stenosis.

INTRODUCTION: The success of radiofrequency energy catheter ablation for the treatment of patients with paroxysmal or chronic atrial fibrillation has been complicated by postablation development of pulmonary vein (PV) stenosis. The acute effect of heat on PV structure has not been well characterized. The aim of this study was to characterize the effects of hyperthermic exposure on PVs and to determine the critical temperature at which PV stenosis would be observed. METHODS AND RESULTS: The main PVs of acutely explanted canine hearts were identified, isolated, and dissected from the left atria. Measurements of the diameter of 3-mm PV rings were obtained at baseline and after hyperthermic exposure at 60 degrees C, 65 degrees C, 70 degrees C, and 80 degrees C. Mechanical behavior of PVs was studied by examining the stress-strain relationship of each PV specimen after heat exposure at different temperature settings. Twenty-eight PVs samples from 15 dogs (1-3 PVs/dog) were obtained and had a mean circumference of 8.7 +/- 2.3 mm at baseline. After heating to 60 degrees C, 65 degrees C, 70 degrees C, and 80 degrees C, the mean PV circumference was 9.2 +/- 2.3 mm (P = NS vs baseline), 6.8 +/- 2.3 mm (P < 0.0001), 4.2 +/- 1.5 mm (P < 0.0001), and 4.2 +/- 0.8 mm (P < 0.0001), respectively. The stress-strain curves of PV specimens were shifted to the left upon exposure to higher temperatures, indicating loss of compliance of PVs due to heat exposure. Histology showed loss of typical collagen matrix above 60 degrees C. CONCLUSION: Significant acute heat-induced contraction of PVs at zero-tension state was observed between 60 degrees C and 65 degrees C. This change was associated with collagen denaturation.

Animals↗
PubMed1994

Stenosis of pulmonary veins with ventricular septal defect: visualization of the pulmonary veins after pulmonary arterial banding.

A case of 'absent' left pulmonary vein with ventricular septal defect was diagnosed based on echocardiography, magnetic resonance imaging and cardiac catheterization at newborn stage. Pulmonary arterial banding was performed at the age of 1 month to ameliorate the pulmonary flow. At a cardiac catheterization 1 year later, the left pulmonary veins were visualized with moderate stenosis at their entrance into the left atrium. The patient has been stable after surgical repair of the ventricular septal defect and dilation of the pulmonary venous stenosis.

Cardiac Catheterization↗
PubMed2005

A rare case of dilatation of pulmonary veins and pulmonary emphysema in both lower lobes.

A 34-year-old man was admitted to hospital because of persistent shortness of breath and diffuse vascular dilation at both lower fields of his CXR. Bronchiectasis had been suspected during childhood because of abnormal chest shadows. However, a chest CT scan obtained on admission failed to show bronchiectasis, but rather there was a dilation of blood vessels and low attenuation areas in both lower lobes. A pulmonary angiogram showed normal pulmonary arteries in the arterial phase and diffuse dilated veins in the venous phase. Although the patient also had liver cirrhosis type B with portal hypertension, no association could be found between his liver cirrhosis and the lung lesions. This is a rare case of possible congenital or idiopathic diffuse dilatation of the pulmonary veins.

Adult↗
PubMed1978

Demonstration of pulmonary arteries by contrast injection into pulmonary vein.

Pulmonary venous injection of contrast medium in the near-wedge position produced a flow into the pulmonary arterial tree in 15 out of 21 children with cyanotic congenital heart disease. In 5 there was good opacification of both sides from a single injection. The technique provides an additional method of demonstrating the anatomy of the pulmonary arteries where surgical treatment is contemplated.

Adolescent↗
PubMed1990

[Mixed type total anomalous pulmonary venous connection with the left upper pulmonary vein draining into the innominate vein and the other pulmonary veins into the coronary sinus--surgical correction in 2 infants].

Surgical repair of the mixed type total anomalous pulmonary venous connection (TAPVC) in infancy is known to be difficult. In this report, experience of two infants with the mixed type TAPVC with the left upper pulmonary vein (PV) draining into the innominate vein and the other PVs into the coronary sinus (IIa + Ia (left upper PV) type TAPVC) is presented. In such cases, it has been said that the left upper PV should be left uncorrected, but we anastomosed the left upper PV, that was thin and fragile, to the left atrium and corrected all the other anomalous PVs. The results were satisfactory. Recently, Extra-Corporeal circulation, microsurgery, and other techniques have significantly progressed, so we consider that the anastomosis is possible in most infants with IIa + Ia (left upper PV) type TAPVC. In the future, careful clinical follow-up and repeat catheterizations should be done, and we'd like to examine the long term patency of the left upper PV.

Anastomosis, Surgical↗
PubMed2006

Predictors of success after selective pulmonary vein isolation of arrhythmogenic pulmonary veins for treatment of atrial fibrillation.

BACKGROUND: Atrial fibrillation (AF) ablation procedures typically involve isolation of all pulmonary veins (PVs) in addition to adjunctive linear lesions, yet the need for such an extensive ablation strategy in all patients is unclear. OBJECTIVES: The purpose of this study was to identify a subgroup of patients undergoing AF ablation with good clinical success after limited PV isolation. METHODS: Patients (N = 450) underwent trigger-guided segmental isolation of only arrhythmogenic PVs. We compared clinical characteristics of patients who required isolation of only one or two PVs to those in whom AF ablation required isolating > or = 3 PVs. RESULTS: For the group of patients undergoing isolation of < or = 2 PVs, AF freedom without antiarrhythmic drug use was achieved in 56 (58%) of 97 patients, and AF control was achieved in 66 (68%) of 97 patients after a single procedure. After additional procedures, 77 (79%) of 97 patients achieved complete AF freedom without antiarrhythmic drugs, and 82 (85%) of 97 patients achieved AF control. Younger age (odds ratio [OR] 1.05; confidence interval [CI] 1.01,1.09) and lack of persistent AF (OR 3.27; CI 1.0, 10.7) were each independent predictors of freedom from AF. In patients younger than 50 years with paroxysmal AF undergoing isolation of < or = 2 PVs (n = 44), AF freedom without antiarrhythmic drugs was achieved in 32 (73%) of 44 after a single ablation procedure. CONCLUSION: Targeted PV isolation has a good long-term (18-month) success rate in patients younger than 50 years with paroxysmal AF and < or = 2 PVs triggering AF.

Atrial Fibrillation↗
PubMed1995

Visualization of pulmonary vein obstruction by pulmonary artery wedge injection and documentation by pressure tracings: report of one case with persistent wheezing following correction of total anomalous pulmonary venous connection.

A 21-month-old boy presented with persistent wheezing 16.5 months after cardiac surgery for supracardiac total anomalous pulmonary venous connection. He had presented at birth with cyanosis and at the age of 25 days, underwent initial cardiac surgery in the form of anastomosis of the pulmonary venous confluence to the left atrium. Non-invasive investigations including transthoracic and transesophageal echocardiograms revealed stenosis of the right pulmonary veins. Visualization and documentation of right pulmonary vein obstruction by pulmonary arterial wedge angiography and pressure tracings are presented.

Anastomosis, Surgical↗
PubMed1987

Postnatal atresia of extraparenchymal pulmonary veins, fulminant necrotizing pulmonary arteritis and elevated circulating immune complexes.

An infant with operatively corrected total anomalous pulmonary venous connection developed postnatal atresia of the extraparenchymal left pulmonary veins with secondary arteritis of the ipsilateral intraparenchymal pulmonary arteries. Atresia of the right or left main pulmonary veins or of the common pulmonary vein is a rare occurrence and it is believed that association of such with necrotizing pulmonary arteritis has never been reported. This case illustrates the potential consequences of severe pulmonary venous obstruction in the absence of a left to right shunt.

Angiography↗
PubMed2006

Is circumferential pulmonary vein isolation preferable to stepwise segmental pulmonary vein isolation for patients with paroxysmal atrial fibrillation?

BACKGROUND: Stepwise segmental pulmonary vein isolation (SPVI) and circumferential pulmonary vein isolation (CPVI) have been developed to treat patients with atrial fibrillation (AF), but the preferable approach for paroxysmal AF (PAF) has not been established. METHODS AND RESULTS: One hundred and ten patients with symptomatic PAF were randomized into a stepwise SPVI group (n=55) or CPVI group (n=55). Systemic SPVI combined with left atrial linear ablation tailored by inducibility of AF was performed in the stepwise SPVI group. Circumferential linear ablation around the left and right-sided pulmonary veins (PVs) guided by 3-dimensional electroanatomic mapping was performed in the CPVI group. The endpoints of ablation are non-induciblity of AF in the stepwise SPVI group and continuity of circular lesions combined with PV isolation in the CPVI group. After the initial procedures, atrial tachyarrhythmis (ATa) recurred within the first 3 months in 23 of the 55 patients (41.8%) who underwent stepwise SPVI and in 20 of the 55 patients (36.4%) who had CPVI (p=0.69). Repeat procedures were performed in 7 patients from the stepwise SPVI group and 5 from the CPVI group (p=0.76). During the 3-9 months after the last procedure, 46 patients (83.6%) from the CPVI group and 43 (78.2%) from the stepwise SPVI group did not have symptomatic ATa while not taking anti-arrhythmic drugs (p=0.63). Severe subcutaneous hematoma or PV stenosis occurred in 3 patients. CONCLUSIONS: The efficacy of stepwise SPVI is comparable to that of CPVI for patients with PAF.

Adult↗
PubMed2005

Percutaneous pulmonary vein stenting for the treatment of severe stenosis after pulmonary vein isolation.

INTRODUCTION: 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. METHODS AND 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. CONCLUSION: 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.

Angioplasty, Balloon↗