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胸腔镜肺切除术治疗心房颤动消融术后慢性肺静脉狭窄继发的大量咯血。

Thoracoscopic pneumonectomy for massive haemoptysis secondary to chronic pulmonary vein stenosis post-atrial fibrillation ablation.

作者信息

Osuga Fumie, Minegishi Kentaro, Endo Shunsuke, Tsubochi Hiroyoshi

机构信息

Department of General Thoracic Surgery, Jichi Medical University, Saitama Medical Center, Saitama-shi, Saitama 330-8503, Japan.

出版信息

Interdiscip Cardiovasc Thorac Surg. 2025 Aug 5;40(8). doi: 10.1093/icvts/ivaf166.

Abstract

Pulmonary vein (PV) stenosis is a rare but serious complication after transcatheter ablation for atrial fibrillation, potentially leading to massive haemoptysis. We present a case of severe PV stenosis resulting in haemoptysis. A 57-year-old man presented with haemoptysis 18 months after catheter ablation. His left PV was almost completely occluded and required the left pneumonectomy. Pathological examination revealed irreversible fibrosis of the PV intima, which led to pulmonary congestion. Surgical intervention resolved the haemoptysis. Anatomical pulmonary resection is required for massive haemoptysis caused by PV stenosis that occurs long after transcatheter ablation.

摘要

肺静脉狭窄是经导管消融治疗心房颤动后一种罕见但严重的并发症,可能导致大量咯血。我们报告一例因严重肺静脉狭窄导致咯血的病例。一名57岁男性在导管消融术后18个月出现咯血。他的左肺静脉几乎完全闭塞,需要进行左肺切除术。病理检查显示肺静脉内膜不可逆纤维化,导致肺淤血。手术干预解决了咯血问题。对于导管消融术后很长时间发生的肺静脉狭窄引起的大量咯血,需要进行解剖性肺切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2717/12341673/f2392e934ee1/ivaf166f1.jpg

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