Bifurcation angioplasty using drug eluting stents of post-AF ablation severe pulmonary vein stenosis.

A 53-year-old man with long-standing persistent AF underwent multiple ablation procedures. A presentation with hemoptysis led to a left pulmonary artery wedge angiography and thoracic computed tomography (CT) scan, which revealed a tight bifurcation stenosis of the left superior pulmonary vein (LSPV). This was treated by angioplasty with drug-eluting stents to avoid restenosis by bare-metal stent implantation in small diameter PVs as already described. After predilatation, two 4 × 32-mm and a 3 × 20-mm Taxus® Liberté stents (Boston Scientific, Natick, MA, USA) were deployed across upper and lower LSPV branches and the ostio-antral segment. Twenty-two month follow-up CT angiography showed patent stents in the LSPV, without in-stent restenosis (no arrhythmia or hemoptysis at 24-month follow-up).