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肺静脉狭窄的发病机制、评估和管理:JACC 每周综述专题。

Pathogenesis, Evaluation, and Management of Pulmonary Vein Stenosis: JACC Review Topic of the Week.

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: https://twitter.com/tjsimard.

Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: https://twitter.com/SarmaDhruv.

出版信息

J Am Coll Cardiol. 2023 Jun 20;81(24):2361-2373. doi: 10.1016/j.jacc.2023.04.016.

Abstract

Pulmonary vein stenosis (PVS) can arise from several etiologies, including congenital, acquired, and iatrogenic sources. PVS presents insidiously, leading to significant delays in diagnosis. A high index of suspicion and dedicated noninvasive evaluation are key to diagnosis. Once diagnosed, both noninvasive and invasive evaluation may afford further insights into the relative contribution of PVS to symptoms. Treatment of underlying reversible pathologies coupled with transcatheter balloon angioplasty and stenting for persistent severe stenoses are established approaches. Ongoing refinements in diagnostic modalities, interventional approaches, postintervention monitoring, and medical therapies hold promise to further improve patient outcomes.

摘要

肺静脉狭窄(PVS)可由多种病因引起,包括先天性、获得性和医源性病因。PVS 隐匿起病,导致诊断明显延迟。高度怀疑和专门的非侵入性评估是诊断的关键。一旦诊断出 PVS,非侵入性和侵入性评估都可能进一步了解 PVS 对症状的相对贡献。治疗潜在的可逆转病变,结合经导管球囊血管成形术和支架置入术治疗持续严重狭窄是既定的方法。在诊断方式、介入方法、介入后监测和药物治疗方面的不断改进有望进一步改善患者的预后。

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