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多次导管消融术后严重肺静脉狭窄引起的难治性咯血。

Refractory Hemoptysis Caused by Severe Pulmonary Vein Stenosis after Multiple Catheter Ablations.

机构信息

Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan.

Division of Respiratory Medicine, Department of Internal Medicine, The Jikei University School of Medicine, Japan.

出版信息

Intern Med. 2021;60(20):3279-3284. doi: 10.2169/internalmedicine.6513-20. Epub 2021 Oct 15.

DOI:10.2169/internalmedicine.6513-20
PMID:34657907
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8580755/
Abstract

We herein report a 48-year-old man with a history of chronic atrial fibrillation (AF) and repeated hemoptysis after radiofrequency ablation. Contrast tomography showed soft tissue thickening of the left hilar region and left pulmonary vein stenosis. We performed bronchial artery embolization, but the hemoptysis did not disappear, and AF was not controlled. We performed left lung lobectomy and maze procedures since we considered surgical removal necessary as radical treatment. After the surgery, hemoptysis and atrial fibrillation did not recur. Refractory hemoptysis after catheter ablation is rare, but occasionally occurs in patients with severe pulmonary vein stenosis.

摘要

我们在此报告一例 48 岁男性，患有慢性心房颤动（AF）病史，射频消融术后反复咯血。对比断层扫描显示左肺门区软组织增厚，左肺静脉狭窄。我们进行了支气管动脉栓塞，但咯血并未消失，AF 也未得到控制。我们考虑到作为根治性治疗有必要进行手术切除，因此进行了左肺叶切除术和迷宫手术。手术后，咯血和心房颤动均未再复发。射频消融术后难治性咯血较为罕见，但在严重肺静脉狭窄患者中偶有发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/5ef096dcba5e/1349-7235-60-3279-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/bae250d4f4db/1349-7235-60-3279-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/d45f28dbd614/1349-7235-60-3279-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/e6140adfaf68/1349-7235-60-3279-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/d6eb4999f8a0/1349-7235-60-3279-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/18b7beac9990/1349-7235-60-3279-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/5ef096dcba5e/1349-7235-60-3279-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/bae250d4f4db/1349-7235-60-3279-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/d45f28dbd614/1349-7235-60-3279-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/e6140adfaf68/1349-7235-60-3279-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/d6eb4999f8a0/1349-7235-60-3279-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/18b7beac9990/1349-7235-60-3279-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/640a/8580755/5ef096dcba5e/1349-7235-60-3279-g006.jpg

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本文引用的文献

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Hemoptysis after five months of cryoballoon ablation: What is the relationship?冷冻球囊消融术后五个月出现咯血：两者有何关系？
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Clinical and Angiographic Characteristics of 35 Patients With Cryptogenic Hemoptysis.35例隐源性咯血患者的临床及血管造影特征
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