B-PO03-107 DETECTION OF A LINEAR INCREASE IN THE NUMBER OF NON-PULMONARY VEIN TRIGGERS FROM PAROXYSMAL TO PERSISTENT AND LONG-STANDING PERSISTENT AF IN PATIENTS UNDERGOING REPEAT PROCEDURE AFTER SUCCESSFUL ISOLATION OF PULMONARY VEINS

Abstract Metastatic renal cell carcinoma with involvement through the pulmonary veins to the left atrium is very rare. We report the case of a 70-year-old male with metastatic renal cell carcinoma to the right lower lobe of the lung abutting the inferior pulmonary vein with extension to the left atrium without pre-operative evidence. Surgical resection was achieved through a posterolateral thoracotomy. Lung masses that abut the pulmonary veins should prompt further investigation with a pre-operative transoesophageal echocardiogram to minimize unexpected intraoperative findings.

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Spontaneous Pulmonary Vein Firing in Man: Relationship to Tachycardia-Pause Early Afterdepolarizations and Triggered Arrhythmia in Canine Pulmonary Veins In Vitro

Journal of Cardiovascular Electrophysiology ◽

10.1111/j.1540-8167.2007.00909.x ◽

2007 ◽

Vol 18 (10) ◽

pp. 1067-1075 ◽

Cited By ~ 73

Author(s):

EUGENE PATTERSON ◽

WARREN M. JACKMAN ◽

KAREN J. BECKMAN ◽

RALPH LAZZARA ◽

DEBORAH LOCKWOOD ◽

...

Keyword(s):

Pulmonary Vein ◽

Pulmonary Veins ◽

Early Afterdepolarizations

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XXII. Note on independent pulsation of the pulmonary veins and vena cava

Proceedings of the Royal Society of London ◽

10.1098/rspl.1876.0041 ◽

1877 ◽

Vol 25 (171-178) ◽

pp. 174-176 ◽

Cited By ~ 25

Keyword(s):

Pulmonary Vein ◽

Jugular Vein ◽

Artificial Respiration ◽

Pulmonary Veins ◽

Vena Cava

In a former communication we incidentally mentioned that in a rabbit killed by the injection of cobra-poison into the jugular vein we had observed the pulmonary vein pulsating after all motion had ceased in the cavities of the heart. We have since observed the same phenomenon three or four times under conditions which show that this pulsation is not due to the action of the cobra-poison with which the animal in which we first observed it had been killed. The following example will show the changes in rhythm observed in these pulsations. A cat was chloroformed, and the vagi exposed and irritated by an interrupted current. Artificial respiration was kept up by air containing chloroform vapour, and the thorax was then opened, and a solution of atropia injected directly into the heart by means of a Wood’s syringe. The vagi were again irritated, but without any effect being produced on the heart, the inhibitory apparatus in it being evidently paralyzed by the atropia. A solution of glycerine extract of physostigma was now injected into the heart in a similar way. The vagi were now irritated again, and the heart stood still, the effect of the atropia having been counteracted by the physostigma. After the irritation ceased the heart again commenced to pulsate.

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The High Road or the Low Road? A Question Regarding Whether to Use Upper or Lower Pulmonary Veins in Measuring Pulmonary Vein Flow

Journal of the American Society of Echocardiography ◽

10.1016/j.echo.2021.05.018 ◽

2021 ◽

Author(s):

Yuichi Baba ◽

Toru Kubo ◽

Hiroaki Kitaoka

Keyword(s):

Pulmonary Vein ◽

Pulmonary Veins ◽

Pulmonary Vein Flow ◽

High Road

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Correlation of Intravascular Ultrasound with Histology in Pediatric Pulmonary Vein Stenosis

Children ◽

10.3390/children8030193 ◽

2021 ◽

Vol 8 (3) ◽

pp. 193

Author(s):

Ryan Callahan ◽

Zachary Gauthier ◽

Shuhei Toba ◽

Stephen P. Sanders ◽

Diego Porras ◽

...

Keyword(s):

Pulmonary Vein ◽

Intravascular Ultrasound ◽

Pulmonary Veins ◽

Pulmonary Vein Stenosis ◽

Elastic Fibers ◽

Gradual Transition ◽

Wall Thickening ◽

Thin Wall ◽

Myxoid Matrix ◽

Vein Stenosis

Preliminary intravascular ultrasound (IVUS) images of suspected pediatric intraluminal pulmonary vein stenosis (PVS) demonstrate wall thickening. It is unclear how the IVUS-delineated constituents of wall thickening correlate with the histology. We analyzed six postmortem formalin-fixed heart/lung specimens and four live patients with PVS as well as control pulmonary veins using IVUS and light microscopic examination. In PVS veins, IVUS demonstrated wall thickening with up to two layers of variable echogenicity, often with indistinct borders. Histologically, the veins showed fibroblastic proliferation with areas rich in myxoid matrix as well as areas with abundant collagen and elastic fibers. Discrete vein layers were obscured by scarring and elastic degeneration. A lower reflective periluminal layer by IVUS corresponded with hyperplasia of myofibroblast-like cells in abundant myxoid matrix. The hyper-reflective layer by IVUS extended to the outer edge of the vessel and corresponded to a less myxoid area with more collagen, smooth muscle and elastic fibers. The outer less reflective edge of the IVUS image correlated with a gradual transition into adventitia. Normal veins had a thin wall, correlating with histologically normal cellular and extracellular components, without intimal proliferation. IVUS may provide further understanding of the anatomy and mechanisms of pediatric pulmonary vein obstruction.

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Relationship between Clinical Features and Histopathologic Findings in Patients with Pulmonary Vein Stenosis

Ukrainian journal of cardiovascular surgery ◽

10.30702/ujcvs/19.3505/044061-063 ◽

2019 ◽

pp. 61-63 ◽

Cited By ~ 1

Author(s):

Y. Mykychak ◽

D. Kozhokar ◽

I. Yusifli ◽

O. Yachnik ◽

V. Zakharova ◽

...

Keyword(s):

Pulmonary Vein ◽

Clinical Features ◽

Pulmonary Veins ◽

Clinical Manifestations ◽

Lung Parenchyma ◽

Pulmonary Vein Stenosis ◽

Pathophysiological Mechanism ◽

Patient Groups ◽

Vein Stenosis ◽

Histopathologic Findings

Pulmonary vein stenosis (PVS) is a rare but serious condition characterized by obstruction of extrapulmonary segments of pulmonary veins which leads to progressive pulmonary hypertension. Objective. In this study we aimed to determine relationship between clinical features and histopathologic findings in patients with PVS. Material and methods. We retrospectively reviewed 34 consecutive patients who underwent PV stenosis repair. Surgical wedge biopsy specimens were collected intraoperatively in 11 patients and reviewed using light microscopy. Results. Affected pulmonary veins in patients with primary PVS were characterized by diffuse stenosis extending into the lung parenchyma. In post-surgical group stenosis was found in a limited segment of pulmonary vein at its ostium. Microscopically, abnormal intimal proliferation was identified in both patient groups. Scaring was predominant finding in patients with post-surgical PVS. Conclusion. In patients with PVS, pathophysiological mechanism influences the severity and extent of clinical manifestations. A comprehensive understanding of this mechanism may improve results of the treatment.

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Box Isolation of the Confluence of 3 Pulmonary Veins, a Rare Variant of the Common Pulmonary Vein

Circulation Journal ◽

10.1253/circj.cj-20-0968 ◽

2020 ◽

Vol 85 (1) ◽

pp. 81

Author(s):

Akio Chikata ◽

Takeshi Kato ◽

Shuhei Fujita ◽

Kazuo Usuda ◽

Masayuki Takamura

Keyword(s):

Pulmonary Vein ◽

Rare Variant ◽

Pulmonary Veins ◽

The Common ◽

Common Pulmonary Vein

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Catecholaminergic automatic activity in the rat pulmonary vein: electrophysiological differences between cardiac muscle in the left atrium and pulmonary vein

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00256.2009 ◽

2009 ◽

Vol 297 (1) ◽

pp. H102-H108 ◽

Cited By ~ 29

Author(s):

Nicolas Doisne ◽

Véronique Maupoil ◽

Pierre Cosnay ◽

Ian Findlay

Keyword(s):

Membrane Potential ◽

Electrical Activity ◽

Cardiac Muscle ◽

Left Atrium ◽

Pulmonary Vein ◽

Pulmonary Veins ◽

Muscle Membrane ◽

Resting Membrane Potential ◽

Ectopic Activity ◽

Automatic Activity

Ectopic activity in cardiac muscle within pulmonary veins (PVs) is associated with the onset and the maintenance of atrial fibrillation in humans. The mechanism underlying this ectopic activity is unknown. Here we investigate automatic activity generated by catecholaminergic stimulation in the rat PV. Intracellular microelectrodes were used to record electrical activity in isolated strips of rat PV and left atrium (LA). The resting cardiac muscle membrane potential was lower in PV [−70 ± 1 (SE) mV, n = 8] than in LA (−85 ± 1 mV, n = 8). No spontaneous activity was recorded in PV or LA under basal conditions. Norepinephrine (10−5 M) induced first a hyperpolarization (−8 ± 1 mV in PV, −3 ± 1 mV in LA, n = 8 for both) then a slowly developing depolarization (+21 ± 2 mV after 15 min in PV, +1 ± 2 mV in LA) of the resting membrane potential. Automatic activity occurred only in PV; it was triggered at approximately −50 mV, and it occurred as repetitive bursts of slow action potentials. The diastolic membrane potential increased during a burst and slowly depolarized between bursts. Automatic activity in the PV was blocked by either atenolol or prazosine, and it could be generated with a mixture of cirazoline and isoprenaline. In both tissues, cirazoline (10−6 M) induced a depolarization (+37 ± 2 mV in PV, n = 5; +5 ± 1 mV in LA, n = 5), and isoprenaline (10−7 M) evoked a hyperpolarization (−11 ± 3 mV in PV, n = 7; −3 ± 1 mV in LA, n = 6). The differences in membrane potential and reaction to adrenergic stimulation lead to automatic electrical activity occurring specifically in cardiac muscle in the PV.

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Asymptomatic Pulmonary Vein Stenosis: Hemodynamic Adaptation and Successful Ablation

Case Reports in Cardiology ◽

10.1155/2016/4979182 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4

Author(s):

John J. Lee ◽

Denis Weinberg ◽

Rishi Anand

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Artery ◽

Pulmonary Vein ◽

Pulmonary Veins ◽

Lung Perfusion ◽

Atrial Fibrillation Ablation ◽

Clinical Severity ◽

Pulmonary Vein Stenosis ◽

Multiple Imaging ◽

Vein Stenosis

Pulmonary vein stenosis is a well-established possible complication following an atrial fibrillation ablation of pulmonary veins. Symptoms of pulmonary vein stenosis range from asymptomatic to severe exertional dyspnea. The number of asymptomatic patients with pulmonary vein stenosis is greater than originally estimated; moreover, only about 22% of severe pulmonary vein stenosis requires intervention. We present a patient with severe postatrial fibrillation (AF) ablation pulmonary vein (PV) stenosis, which was seen on multiple imaging modalities including cardiac computed tomography (CT) angiogram, lung perfusion scan, and pulmonary angiogram. This patient did not have any pulmonary symptoms. Hemodynamic changes within a stenosed pulmonary vein might not reflect the clinical severity of the obstruction if redistribution of pulmonary artery flow occurs. Our patient had an abnormal lung perfusion and ventilation (V/Q) scan, suggesting pulmonary artery blood flow redistribution. The patient ultimately underwent safe repeat atrial fibrillation ablation with successful elimination of arrhythmia.

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Clarifying the anatomy of the superior sinus venosus defect

Heart ◽

10.1136/heartjnl-2021-319334 ◽

2021 ◽

pp. heartjnl-2021-319334

Author(s):

Jay Relan ◽

Saurabh Kumar Gupta ◽

Rengarajan Rajagopal ◽

Sivasubramanian Ramakrishnan ◽

Gurpreet Singh Gulati ◽

...

Keyword(s):

Left Atrium ◽

Pulmonary Vein ◽

Pulmonary Veins ◽

Interatrial Septum ◽

Sinus Venosus ◽

Caval Vein ◽

Therapeutic Implications ◽

Superior Caval Vein ◽

Inferior Pulmonary Vein ◽

The Right

ObjectivesWe sought to clarify the variations in the anatomy of the superior cavoatrial junction and anomalously connected pulmonary veins in patients with superior sinus venosus defects using computed tomographic (CT) angiography.MethodsCT angiograms of 96 consecutive patients known to have superior sinus venosus defects were analysed.ResultsThe median age of the patients was 34.5 years. In seven (7%) patients, the defect showed significant caudal extension, having a supero-inferior dimension greater than 25 mm. All patients had anomalous connection of the right superior pulmonary vein. The right middle and right inferior pulmonary vein were also connected anomalously in 88 (92%) and 17 (18%) patients, respectively. Anomalous connection of the right inferior pulmonary vein was more common in those with significant caudal extension of the defect (57% vs 15%, p=0.005). Among anomalously connected pulmonary veins, the right superior, middle, and inferior pulmonary veins were committed to the left atrium in 6, 17, and 11 patients, respectively. The superior caval vein over-rode the interatrial septum in 67 (70%) patients, with greater than 50% over-ride in 3 patients.ConclusionAnomalous connection of the right-sided pulmonary veins is universal, but is not limited to the right upper lobe. Not all individuals have over-riding of superior caval vein. In a minority of patients, the defect has significant caudal extension, and anomalously connected pulmonary veins are committed to the left atrium. These findings have significant clinical and therapeutic implications.

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