Hämoptysen infolge Pulmonalvenenstenose und -verschluss nach Pulmonalvenen-Isolation bei Vorhofflimmern

Publikation: Beitrag in FachzeitschriftFallbericht (Case report)BeigetragenBegutachtung

Beitragende

Abstract

HISTORY AND ADMISSION FINDINGS: A 49-year-old woman was admitted because of hemoptysis for four months. Several bronchoscopies and thoracic computed tomographies at other hospitals had not revealed the cause of the sustained hemoptysis. Eight months before admission she had undergone pulmonary vein ablation (PVA) for paroxysmal atrial fibrillation. After the PVA she had initially received oral anticoagulation, but this had been stopped because of the hemoptysis. Physical examination at admission to our hospital was unremarkable except for moderate obesity and arterial hypertension

INVESTIGATIONS: Ventilation/perfusion scintigraphy demonstrated combined ventilation and perfusion deficits in the left lower lobe. Transesophageal echocardiography strongly suggested stenoses of the left pulmonary veins. 3-D reconstruction of previously recorded computed tomographic images showed absence of the left inferior pulmonary vein (LIPV) and marked stenosis of the left superior pulmonary vein (LSPV).

DIAGNOSIS: It was confirmed that the hemoptysis was caused by stenosis of the left pulmonary veins, resulting from the previous PVA.

TREATMENT AND COURSE: Percutaneous transseptal balloon dilatation of the upper and lower pulmonary veins was successfully performed. The patient was put on oral anticoagulation and discharged home free of symptoms.

CONCLUSION: Pulmonary vein stenosis must be considered as the most likely cause of hemoptysis and respiratory symptoms after pulmonary vein ablation for atrial fibrillation. Because of ever more frequent interventions to treat atrial fibrillation and other atrial arrhythmias, great clinical vigilance and an interdisciplinary approach is mandatory to assure optimal assessment of patients with acquired pulmonary vein stenosis.

Details

OriginalspracheDeutsch
Seiten (von - bis)626-630
Seitenumfang5
FachzeitschriftDeutsche Medizinische Wochenschrift
Jahrgang136
Ausgabenummer13
PublikationsstatusVeröffentlicht - Apr. 2011
Peer-Review-StatusJa

Externe IDs

researchoutputwizard legacy.publication#42709
PubMed 21432738
ORCID /0000-0001-6022-6827/work/142659545
Scopus 79953051049

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Administration, Oral, Angiography, Anticoagulants/administration & dosage, Atrial Fibrillation/surgery, Catheterization, Combined Modality Therapy, Echocardiography, Transesophageal, Female, Follow-Up Studies, Hemoptysis/etiology, Humans, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Middle Aged, Perfusion Imaging, Postoperative Complications/diagnosis, Pulmonary Veins/surgery, Pulmonary Veno-Occlusive Disease/diagnosis, Tomography, X-Ray Computed, Ventilation-Perfusion Ratio