Key result
ICE-guided pulmonary vein stenting restores venous flow and relieves dyspnea in tumor-induced stenosis.
Why the study?
Pulmonary vein stenosis caused by cardiac tumors is rare, and experience with transcatheter pulmonary vein stenting is limited.
Does ICE-guided pulmonary vein stenting improve symptoms and restore venous flow in a patient with severe pulmonary vein stenosis caused by a left atrial tumor?
Case Report (n=1)
Does ICE-guided pulmonary vein stenting improve symptoms and restore venous flow in a patient with severe pulmonary vein stenosis caused by a left atrial tumor?
ICE-guided transcatheter pulmonary vein stenting can be a safe and effective palliative option for symptomatic relief in poor surgical candidates with malignancy-related pulmonary vein stenosis.
May offer palliative relief via ICE-guided stenting in tumor-related pulmonary vein stenosis; leaves open questions on durability and generalizability.
Background Pulmonary vein stenosis (PVS) caused by a cardiac tumor is rare, and experience with transcatheter pulmonary vein stenting is limited. We report a challenging case of symptomatic PVS managed with intracardiac echocardiography (ICE)–guided pulmonary vein stenting as palliative treatment. Case An 83-year-old woman presented with progressive dyspnea for 4 months. Electrocardiography, chest x-ray, and routine laboratory tests were unremarkable. Transthoracic echocardiography revealed a large left atrial mass involving the right pulmonary vein and causing stenosis. Multimodality imaging, including cardiac computed tomography (CT), cardiac magnetic resonance imaging, and 1 ⁸F-FDG PET/CT, suggested primary cardiac angiosarcoma. Considering the patient's advanced age and poor surgical candidacy, we selected a palliative transcatheter intervention. Under ICE guidance, transseptal puncture was performed. Pulmonary venography revealed severe stenosis of the right inferior pulmonary vein. After sequential balloon angioplasty, a 14 × 40 mm self-expanding stent was successfully implanted with adjunctive balloon dilation. Final angiography demonstrated complete restoration of pulmonary venous flow without residual stenosis or procedural complications. The patient's dyspnea improved markedly, and she was discharged 2 days after the procedure. Conclusion In selected patients with PVS who are unsuitable for surgical treatment, ICE-guided pulmonary vein stenting can be performed safely and may provide effective palliation by restoring pulmonary venous flow and relieving symptoms.
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Shin et al. (2026) conducted a case report in Pulmonary vein stenosis (n=1). Intracardiac echocardiography-guided pulmonary vein stenting was evaluated on Symptom relief and restoration of pulmonary venous flow. Intracardiac echocardiography-guided pulmonary vein stenting safely restored pulmonary venous flow and markedly relieved dyspnea in a patient with tumor-induced pulmonary vein stenosis.
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