Paclitaxel-coated drug-eluting balloon for pulmonary vein stenosis after repair of total anomalous pulmonary venous return with asplenia

Background: Infracardiac obstructive total anomalous pulmonary venous return (TAPVR) has a poor outcome following surgical correction. We compared the surgical outcomes of obstructive TAPVR between non-infracardiac and infracardiac types. Methods: Among 51 patients who underwent surgical repair for obstructive TAPVR, 23 with infracardiac type and 28 with non-infracardiac type were included in this investigation. The study compared the immediate postoperative courses in the intensive care unit and long-term mortality and pulmonary vein stenosis. The risk factors for long-term survival in obstructive TAPVR also were investigated. Results: The postoperative follow-up period was 79.8 ± 81.5 months. Immediate major operative complications were observed in 22 patients (43.1%); 10 patients (19.6%) died, and eight patients (15.7%) experienced pulmonary vein stenosis during the follow-up period. The Kaplan-Meier curve showed better cumulative survival in patients with infracardiac TAPVR (P = 0.308). The significant factors for survival after surgical repair of obstructive TAPVR did not include anatomical type but instead were postoperative course of ventilator care and lengths of intensive care unit and hospital stays. Conclusion: Patients with non-infracardiac TAPVR with obstruction had a longer postoperative course and experienced more complications. Their survival rate was poorer, and postoperative pulmonary vein stenosis was more frequent in those patients compared with infracardiac TAPVR patients. However, a large-scale study is mandatory to gather more data and confirm our findings.

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Surveillance of a Patient Born With Tetralogy of Fallot and Total Anomalous Pulmonary Venous Return With Recurrent Pulmonary Vein Stenosis: The Role of Echocardiography to Aid in Treatment Options

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479320952070 ◽

2020 ◽

Vol 36 (6) ◽

pp. 580-584

Author(s):

Dana Jones

Keyword(s):

Tetralogy Of Fallot ◽

Pulmonary Vein ◽

Venous Return ◽

Treatment Options ◽

Pulmonary Veins ◽

Pulmonary Vein Stenosis ◽

Interventional Treatment ◽

Anomalous Pulmonary Venous Return ◽

Vein Stenosis

Surveillance of patients with congenital heart disease is difficult in some clinical settings. This case study follows the progress of a patient, born with prenatally missed diagnoses of tetralogy of Fallot (TOF) and total anomalous pulmonary venous return (TAPVR), for over two years. The patient acquired pulmonary vein stenosis following initial TOF/TAPVR repair, which made the case an interesting longitudinal study. Multiple cardiac catheterizations for stents and balloon angioplasties of the pulmonary veins were necessary. This case study illustrates this patient’s success with treatment options such as chemotherapy medications, as well as the failure of each treatment. It was also important to note that the interval of time between each interventional treatment weighed heavily upon results of frequent echocardiograms.

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Clinical outcomes after the endovascular treatments of pulmonary vein stenosis in patients with congenital heart disease

Cardiology in the Young ◽

10.1017/s1047951119001495 ◽

2019 ◽

Vol 29 (8) ◽

pp. 1057-1065 ◽

Cited By ~ 1

Author(s):

Yoshihiko Kurita ◽

Kenji Baba ◽

Maiko Kondo ◽

Takahiro Eitoku ◽

Shingo Kasahara ◽

...

Keyword(s):

Pulmonary Vein ◽

Stent Implantation ◽

Bare Metal Stent ◽

Pulmonary Vein Stenosis ◽

Drug Eluting Stent ◽

Bare Metal ◽

Metal Stent ◽

Significant Difference ◽

Drug Eluting ◽

Vein Stenosis

AbstractBackground:Pulmonary vein stenosis (PVS) is a condition with challenging treatment and leads to severe cardiac failure and pulmonary hypertension. Despite aggressive surgical or catheter-based intervention, the prognosis of PVS is unsatisfactory. This study aimed to assess the prognosis and to establish appropriate treatment strategies.Methods:We retrospectively reviewed endovascular treatments for PVS (2001–2017) from the clinical database at the Okayama University Hospital.Results:A total of 24 patients underwent PVS associated with total anomalous pulmonary venous connection and 7 patients underwent isolated congenital PVS. In total, 53 stenotic pulmonary veins were subjected to endovascular treatments; 40 of them were stented by hybrid (29) and percutaneous procedures (11) (bare-metal stent, n = 34; drug-eluting stent, n = 9). Stent size of hybrid stenting was larger than percutaneous stenting. Median follow-up duration from the onset of PVS was 24 months (4–134 months). Survival rate was 71 and 49% at 1 and 5 years, respectively. There was no statistically significant difference between stent placement and survival; however, patients who underwent bare-metal stent implantation had statistically better survival than those who underwent drug-eluting stent implantation or balloon angioplasty. Early onset of stenosis, timing of stenting, and small vessel diameter of pulmonary vein before stenting were considered as risk factors for in-stent restenosis. Freedom from re-intervention was 50 and 26% at 1 and 2 years.Conclusions:To improve survival and stent patency, implantation of large stent is important. However, re-intervention after stenting is also significant to obtain good outcome.

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