Spadaro Savino, Saturni Sara, Cadorin Delia, Colamussi Maria V, Bertini Matteo, Galeotti Roberto, Cappato Riccardo, Ravenna Franco, Volta Carlo A
Department of Morphology, Surgery and Experimental Medicine, Section of Anesthesia and Intensive care, University of Ferrara, Via Aldo Moro, 8, Ferrara, 44121, Italy.
Department of Morphology, Surgery and Experimental Medicine, Respiratory Medicine, S.Anna Hospital, Ferrara, Italy.
BMC Pulm Med. 2015 Oct 24;15:128. doi: 10.1186/s12890-015-0121-0.
Atrial fibrillation (AF) can be treated with percutaneous catheter ablation procedures into the left atrium. Pulmonary veins stenosis (PV) stenosis is a severe complication of this procedure.
we report a case of late hemoptysis secondary to severe PV stenosis in a man who underwent AF ablation 9 months before onset of symptoms. He presented four episodes of bleeding and developed an acute respiratory failure (ARF). Parameters of respiratory mechanics and medical investigation did not show any abnormalities. Only computed tomography (CT) angiography showed stenosis of 3 out of 4 native PVs. PV balloon dilatation in all affected PVs and a stent was implanted in 1 of the 3 PVs with full restoration of respiratory function during 1 year follow-up.
PV stenosis may be the underlying cause of recurrent haemoptysis after AF ablation in the presence of normal respiratory parameters. This diagnosis can be confirmed by means of CT angiography and magnetic resonance imaging can provide accurate localization of stenosis.
心房颤动（AF）可通过经皮导管消融术治疗进入左心房。肺静脉狭窄（PV）是该手术的严重并发症。
我们报告一例9个月前接受房颤消融术的男性患者，在症状出现前因严重肺静脉狭窄继发迟发性咯血。他出现了4次出血发作并发展为急性呼吸衰竭（ARF）。呼吸力学参数和医学检查未显示任何异常。仅计算机断层扫描（CT）血管造影显示4条天然肺静脉中有3条狭窄。对所有受影响的肺静脉进行球囊扩张，并在3条肺静脉中的1条植入支架，在1年随访期间呼吸功能完全恢复。
在呼吸参数正常的情况下，肺静脉狭窄可能是房颤消融术后反复咯血的潜在原因。通过CT血管造影可确诊，磁共振成像可提供狭窄的准确定位。
