Key result
Simultaneous pulmonary vein stenting and LAAO resolves hemoptysis and prevents stroke at 12 months.
Why the study?
Pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation is an uncommon but serious complication with limited treatment options for patients with recurrent AF and high stroke risk.
Case Report (n=1)
No
Supports feasibility of combined PV stenting and LAAO for post-ablation hemoptysis and stroke risk; leaves open need for prospective validation before wider adoption.
Background Pulmonary vein stenosis (PVS) after radiofrequency ablation for non-valvular atrial fibrillation (AF) is an uncommon but serious complication. PVS stenting can rapidly restore pulmonary flow and improve symptoms with long-term low incidence of restenosis. However, high risk of thrombosis remains if AF is recurrent, especially for CHA2DS2-VASc > 2. Case presentation A 67-year-old man with diabetes, hypertension and a history of stroke underwent radiofrequency pulmonary vein isolation for persistent AF 1 year ago. Six months later he developed recurrent respiratory infection and massive hemoptysis. Computed tomography pulmonary angiography revealed severe left pulmonary vein stenosis. Simultaneous percutaneous PVS stenting and left atrial appendage occlusion were performed to resolve recurrent hemoptysis and prevent stroke. The clinical follow-up indicated a good short and mid-term result with significant improvement of symptoms. Conclusions Simultaneous PVS stenting and left atrial appendage occlusion is feasible and effective in patients with recurrence of AF and hemoptysis induced by radiofrequency ablation for AF.
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Li et al. (2020) conducted a case report in Pulmonary vein stenosis with massive hemoptysis and recurrent atrial fibrillation (n=1). Simultaneous percutaneous pulmonary vein stenosis stenting and left atrial appendage occlusion was evaluated on Symptom resolution, restoration of pulmonary venous flow, and absence of device-related thrombosis or restenosis. Simultaneous pulmonary vein stenosis stenting and left atrial appendage occlusion successfully resolved recurrent hemoptysis and prevented stroke without restenosis or thrombosis at 12 months.
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