Hussain Ahmed, Alway Thomas, McCready James, Hildick-Smith David
Department of Cardiology, Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom; Department of Cardiology, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
Department of Cardiology, Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom.
Cardiovasc Revasc Med. 2023 Aug;53S:S288-S291. doi: 10.1016/j.carrev.2023.01.028. Epub 2023 Feb 2.
Pulmonary vein occlusion (PVO) is a known complication of radiofrequency ablation for atrial fibrillation. We present a case with delayed presentation leading to chronic total PVO. Computed Tomography (CT) imaging did not predict the presence of residual flow. Despite this, the occlusion was successfully stented using wire escalation techniques adapted from chronic total occlusion coronary angioplasty, with resolution of symptoms. This emphasises the importance of combining CT with invasive angiography for patient selection and interventional strategy. Innovative angioplasty techniques used to overcome PVO need to be balanced against additional risk of perforation when dealing with extra-cardiac structures.
肺静脉闭塞（PVO）是心房颤动射频消融术的一种已知并发症。我们报告一例出现延迟导致慢性完全性PVO的病例。计算机断层扫描（CT）成像未能预测残余血流的存在。尽管如此，采用源自慢性完全闭塞冠状动脉成形术的导丝升级技术成功地对闭塞病变进行了支架置入，症状得以缓解。这强调了将CT与有创血管造影相结合用于患者选择和介入策略的重要性。用于克服PVO的创新血管成形术技术在处理心外结构时，需要在其与穿孔额外风险之间取得平衡。
