“Half-uncovered technique” to secure larger stents for postoperative pulmonary vein stenosis

Although larger stent placement could be effective for pulmonary vein stenosis, stents extrusion tends to occur due to caliber narrowing, small landing area, and the slippery nature. We placed stents with diameter ≧8 mm for four stenotic lesions using the “half-uncovered technique”. All stents were precisely placed and successfully resolved the stenosis. This technique allows us to avoid extrusion and to perform safe and effective dilatation when placing larger stents for pulmonary vein stenosis.

IVUS guided drug-coated balloon venoplasty for in-stent restenosis in pulmonary veins stenosis: a case report

Background pulmonary veins stenosis after atrial fibrillation radiofrequency ablation is an uncommon complication. When it occurs, percutaneous treatment is the preferred approach. There is a lack of standardized procedures, and when stenting restenosis is relatively common. Case summary we present a young patient with recurrence of pulmonary vein stenosis after a first percutaneous treatment. The recurrence of haemoptysis and dyspnoea after treatment in pulmonary vein stenosis allowed the diagnosis of significant stenosis again in our patient. In the Heart Team we opted for new percutaneous treatment, using IVUS to optimize the final result. Discussion nowadays, percutaneous approach is preferred and among percutaneous treatments for pulmonary veins stenosis, and stenting has shown better results than ballon angioplasty. Despite this, experience in instent restenosis is limited, and there is a lack of adequate and specific material for its approach. In this case we present the possible role of the IVUS and the drug-coated ballon angioplasty in this entity.

Pulmonary Vein Stenosis: Moving From Past Pessimism to Future Optimism

Pulmonary Vein Stenosis (PVS) is a rare disease with a prevalence of around 1. 7 cases per 100,000 children under 2 years old. Treatment options for this disease have not provided great results and pathophysiology of this condition is still poorly understood. Here, we will review the history of PVS including diagnostic tools and treatments, the current management approach, and what the future holds for this devastating disease.

Study on Optimal Parameter and Target for Pulsed-Field Ablation of Atrial Fibrillation

Pulsed-field ablation (PFA) had potential advantages in atrial fibrillation ablation, and we aim to confirm the optimal parameter and target of PFA for atrial fibrillation. Two ablation modes in vitro of single-cell system (ablation in electrode cup) and monolayer cell system (ablation in inserts with electrode tips) were established to perform PFA for myocardial cell H9C2 and smooth muscle cell A7r5. Ablation effect, calcium ion influx, the expression of Cx45, and surface morphological change were observed. Three Bama minipigs were used to verify the in vivo ablation effect of PFA. In monolayer cell system, H9C2 was significantly sensitive to PFA compared with A7r5, with shrinking of the whole monolayer. The ablation effect of bidirectional pulse was weaker than that of the two mono-polar pulses. Expressed Cx45 proteins were increased in H9C2 but decreased in A7r5 cells. Bidirectional PFA performed on Bama minipigs was able to effectively block electrical activity from the pulmonary vein to the atrium with week muscle contraction, not generating pulmonary vein stenosis. Bidirectional PFA was able to significantly ablate myocardial cells, maintain cell–cell connection, and reduce muscle contraction, which was a kind of optimized PFA strategy for atrial fibrillation.