Division of Pediatric Cardiology, Nicklaus Children's Hospital, 3100 SW 62nd Avenue, Miami, FL, 33155, USA.
Curr Cardiol Rep. 2020 Oct 3;22(11):153. doi: 10.1007/s11886-020-01395-x.
Pulmonary vein stenosis (PVS) is a rare entity that until the last 2 decades was seen primarily in infants and children. Percutaneous and surgical interventions have limited success due to relentless restenosis, and mortality remains high. In adults, acquired PVS following ablation for atrial fibrillation has emerged as a new syndrome. This work will review these two entities with emphasis on current treatment.
Greater emphasis on understanding and addressing the mechanism of restenosis for congenital PVS has led to the use of drug-eluting stents (DES) and systemic drug therapy to target neo-intimal growth. Frequent reinterventions are positively affecting outcomes. Longer-term outcomes of percutaneous treatment for acquired PVS are emerging. Treatment of congenital PVS continues to be plagued by restenosis. DES show promise, but frequent reinterventions are required. Larger upstream vein diameter predicts success for congenital and acquired PVS interventions. Efforts to induce/maintain vessel growth are important for future treatment strategies.
肺静脉狭窄（PVS）是一种罕见疾病，直到过去 20 年，主要发生在婴儿和儿童中。由于不断再狭窄，经皮和手术干预的成功率有限，死亡率仍然很高。在成年人中，房颤消融后获得性 PVS 已成为一种新的综合征。本研究将重点介绍这两种疾病，并强调当前的治疗方法。
人们更加重视先天性 PVS 再狭窄机制的理解和处理，导致药物洗脱支架（DES）和全身药物治疗被用于靶向新生内膜生长。频繁的再次介入治疗正在积极影响结局。经皮治疗获得性 PVS 的长期结局正在出现。先天性 PVS 的治疗仍然受到再狭窄的困扰。DES 有应用前景，但需要频繁的再次介入治疗。较大的上游静脉直径可预测先天性和获得性 PVS 干预的成功。诱导/维持血管生长的努力对于未来的治疗策略很重要。
