Sarubbi Berardo, Rea Gaetano, Santoro Giuseppe, Melillo Enrico, Scognamiglio Giancarlo, Russo Maria Giovannna
Monaldi Hospital Naples, Adult Congenital Heart Disease Unit.
Monaldi Arch Chest Dis. 2018 Mar 9;88(1):895. doi: 10.4081/monaldi.2018.895.
One of the major complications of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) is pulmonary vein stenosis (PVS). The natural history of PVS, especially when it involves more than one vein, leads to severe and irreversible pulmonary hypertension with end-stage right heart failure that can require, in extreme cases, even heart-lung transplantation. We report the case of a young patient who underwent RFCA for a single lasting episode of AF and developed PVS years later. He was treated with ballon venoplasty followed by stent implantation in left pulmonary vein because of PVS relief. This reported case emphasizes the need of an adequate indication for RFCA for AF, considering the benefit-risk ratio especially in young patients with normal cardiac function.
心房颤动（AF）射频导管消融术（RFCA）的主要并发症之一是肺静脉狭窄（PVS）。PVS的自然病程，尤其是当它累及多条静脉时，会导致严重且不可逆的肺动脉高压，并伴有终末期右心衰竭，在极端情况下甚至需要进行心肺移植。我们报告了一例年轻患者的病例，该患者因单次持续性AF发作接受了RFCA，数年后出现了PVS。由于PVS得到缓解，他接受了球囊血管成形术，随后在左肺静脉植入了支架。该病例报告强调，在考虑获益风险比时，尤其是对于心功能正常的年轻患者，AF的RFCA需要有充分的适应症。
