Severe Pulmonary Vein Stenosis Presenting With Infection-Like Pulmonary Findings After Radiofrequency Ablation for Atrial Fibrillation: A Case Report

Figures

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  Fig. 1. Computed tomography angiography findings of the left pulmonary veins before and after radiofrequency ablation. (A) Pre-ablation cardiac CTA showing a patent left inferior pulmonary vein. (B) Post-ablation cardiac CTA showing non-visualization of the left inferior pulmonary vein, consistent with complete occlusion. (C) Pre-ablation cardiac CTA showing a patent left superior pulmonary vein. (D) Post-ablation cardiac CTA showing focal stenosis of the left superior pulmonary vein near the left atrium. White arrows indicate patent pulmonary veins before ablation; yellow arrows indicate post-ablation occlusion or stenosis. CTA, computed tomography angiography.

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  Fig. 2. Chest CT and bronchoscopic findings during the infection-like clinical presentation. (A) Chest CT showing a focal high-density opacity in the left lower lung, mimicking pneumonia. The yellow arrow indicates the infection-like pulmonary opacity. (B) Bronchoscopy showing dilated, tortuous, and prominent submucosal vessels in the left main bronchus with mucosal hyperemia. The yellow arrow indicates the abnormal submucosal vascular changes. CT, computed tomography.

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  Fig. 3. Clinical timeline of the patient's presentation, diagnostic evaluation, treatment, and follow-up. The timeline summarizes the clinical course from pre-ablation cardiac CTA to radiofrequency ablation, respiratory presentation, diagnostic work-up, pulmonary vein stenting, and follow-up. AF, atrial fibrillation; BALF, bronchoalveolar lavage fluid; CTA, computed tomography angiography; LIPV, left inferior pulmonary vein; LSPV, left superior pulmonary vein; PV, pulmonary vein; PVI, pulmonary vein isolation; RF, radiofrequency.