Recurrent pneumonia post atrial fibrillation ablation: do not forget to look for pulmonary vein stenosis

Figures

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  Figure 1. Chest CT scan showing ground glass opacities of the left inferior lobe, compatible with a partial venous infarction of the left lower lobe (yellow arrows).

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  Figure 2. Chest CT scan with contrast showing an opacification delay in the left inferior pulmonary vein (yellow arrow) suggestive of stenosis or thrombotic occlusion.

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  Figure 3. Pulmonary CT angiography showing severe stenosis of the left inferior pulmonary vein without complete occlusion (red arrow on the left figure) and three-dimensional reconstruction (yellow arrow on the right figure).

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  Figure 4. Stenting of left inferior pulmonary vein (LIPV) (A): severe stenosis of LIPV in fluoroscopy (yellow arrow on upper figure) and transoesophageal echocardiography (red arrows on lower figure): LIPV systolodiastolic flow mean gradient 4.3 mm Hg and maximum gradient 10 mm Hg. (B) stenting (Omni elite 8.0×19 mm) of LIPV in fluoroscopy (yellow arrow on upper figure) and transoesophageal echocardiography (red arrows on lower figure). (C) Final result in fluoroscopy (yellow arrows on upper figure) and transoesophageal echocardiography (red arrows on lower figure): left inferior pulmonary vein systolo-diastolic flow mean gradient 2 mm Hg and maximum gradient 7 mm Hg