Rare Case of Pulmonary Vein Occlusion Following Mitral Valve Repair: Diagnostic Challenges and Successful Percutaneous Intervention

Pulmonary vein stenosis is a rare, lethal condition posing significant diagnostic and therapeutic challenges. This case report highlights an unusual case of right superior pulmonary vein occlusion and diffuse alveolar hemorrhage following mitral valve repair in a 29–year–old male patient. Initially asymptomatic after the surgery, the patient developed recurrent hemoptysis and exertional breathlessness after 3 months. Comprehensive diagnostic evaluations, including computed tomography (CT) chest scans, bronchoscopy, and CT-guided biopsy, revealed diffuse alveolar hemorrhage and a 12 mm occlusion of the right superior pulmonary vein. The patient underwent a successful percutaneous intervention, which included intravascular ultrasound and the placement of a 7×18 mm Herculink stent, restoring vein patency and alleviating symptoms. This case highlights the importance of considering vascular complications in patients with a history of cardiac surgery who present with respiratory symptoms. Long-term follow-up is essential to monitor for restenosis and ensure ongoing clinical improvement.