Imaging approaches for pulmonary vein isolation in patients after lobectomy or pneumonectomy: a case series

Figures

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  Figure 1. (A) Electrocardiogram of patient Case 1 showing atrial fibrillation (25 mm/s, 10 mm/mV). (B) Electrocardiogram of patient Case 2 showing atrial pacing (50 mm/s, 10 mm/mV). (C) Electrocardiogram of patient Case 3 showing atrial fibrillation (25 mm/s, 10 mm/mV).

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  Figure 2. Patient 1: (A) computed tomography scan. Cor situated in the midline behind the sternum. Right inferior pulmonary vein ‘stump’ 17 × 10 mm. (B) Posterior view focusing on the right-sided pulmonary veins. The right inferior pulmonary vein ‘stump’ is seen on the lower right side. On the left side, a common left pulmonary vein ostium and the left atrial appendage are seen.

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  Figure 3. Patient 2: (A and B) show X-ray images after right-sided pneumonectomy and two-lead pacemaker implantation. (C) Transoesophageal echocardiography image of the bicaval view (here 136° usual 90–110°, angulation and (D) a two-chamber view (here 121°, usual 60° angulation). (E) CARTO anatomy construction and pulmonary vein isolation of the left-sided veins. (F) Fluoroscopic view of the heart (Right Anterior Oblique 40°, analogue to usual ap view), marked with E, the oesophageal thermoprobe.

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  Figure 4. Patient 3: computed tomography images after left-sided pneumonectomy, (A) pulmonic window demonstrating left-sided pneumonectomy, (B) contrast-enhanced views demonstrating the longer left superior pulmonary vein stump (arrow) and (C) the shorter left interior pulmonary vein stump (arrow).