Wongcharoen Wanwarang, Tsao Hsuan-Ming, Wu Mei-Han, Tai Ching-Tai, Chang Shih-Lin, Lin Yenn-Jiang, Chang Cheng-Yen, Chen Shih-Ann
Division of Cardiology and Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taiwan, China.
J Cardiovasc Electrophysiol. 2006 Apr;17(4):423-5. doi: 10.1111/j.1540-8167.2006.00301.x.
Acquired pulmonary vein (PV) stenosis is a well-known complication following catheter ablation of atrial fibrillation (AF). However, the details of congenital PV stenosis have not been reported in patients who underwent catheter ablation of AF.
A total of 178 patients (110 men, age: 54 +/- 11 years) with drug-refractory AF received MRA or multidetector CT (MDCT) before ablation for delineation of PV morphologies. Five PVs in 5 patients (2.8%) showed at least 50% stenosis before ablation. We demonstrated two types of preexisting PV stenosis. Type I is the external compression of PV by the descending aorta, observed in LIPV of the three patients. Type II is the focal narrowing of PV, observed in RSPV of the two patients.
Preexisting stenosis of PV may be a consequence of congenital focal narrowing or external compression by the adjacent structures. Detection of this condition by 3D CT or MRA before catheter ablation can provide information for planning of ablation strategy and prevent misdiagnosis of ablation-related PV stenosis.
获得性肺静脉（PV）狭窄是心房颤动（AF）导管消融术后一种众所周知的并发症。然而，关于接受AF导管消融术的患者先天性PV狭窄的详细情况尚未见报道。
共有178例（110例男性，年龄：54±11岁）药物难治性AF患者在消融术前接受了磁共振血管造影（MRA）或多排螺旋CT（MDCT）检查，以描绘PV形态。5例患者的5条PV（2.8%）在消融术前显示至少50%的狭窄。我们展示了两种预先存在的PV狭窄类型。I型是降主动脉对PV的外部压迫，在3例患者的左肺下静脉（LIPV）中观察到。II型是PV的局灶性狭窄，在2例患者的右上肺静脉（RSPV）中观察到。
预先存在的PV狭窄可能是先天性局灶性狭窄或相邻结构外部压迫的结果。在导管消融术前通过三维CT或MRA检测到这种情况可为消融策略的制定提供信息，并防止对消融相关PV狭窄的误诊。
