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J Interv Card Electrophysiol ; 53(3): 309-315, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29671104

RESUMO

PURPOSE: Symptomatic severe pulmonary vein stenosis (PVS) after catheter ablation of atrial fibrillation (AF) is a rare but well-recognized complication. Treatment options include pulmonary vein angioplasty with or without drug eluting balloons or angioplasty with stent implantation. The treatment of choice is unclear. In our center, pulmonary vein stenting is the treatment of choice for significantly stenotic veins. We present the long-term clinical outcome of 9 patients treated with stent implantation. METHODS: Between 2001 and 2015, 3048 patients with AF were treated with catheter ablation at our institution, of which 9 developed symptomatic PVS. A total of 11 PVS were treated. Pre-procedural imaging (CT, MR, transesophageal echocardiography, angiography) was performed in all patients. RESULTS: Mean time from ablation to stenting was 18 months. Three patients had recurrent pneumonia and the remaining reduced functional capacity (NYHA 2). All patients were in functional capacity NYHA 1 (p < 0.05) after a mean follow-up of 64 (18-132) months. Three patients still had paroxysmal AF, of which two have undergone repeated ablation. CONCLUSIONS: Symptomatic PVS after AF ablation can be successfully treated by stent implantation with durable results and good clinical outcome. AF ablation is still a feasible option after stent deployment.


Assuntos
Fibrilação Atrial/cirurgia , Implante de Prótese Vascular , Ablação por Cateter/efeitos adversos , Efeitos Adversos de Longa Duração , Complicações Pós-Operatórias , Estenose de Veia Pulmonar , Idoso , Angiografia/métodos , Fibrilação Atrial/epidemiologia , Implante de Prótese Vascular/instrumentação , Implante de Prótese Vascular/métodos , Ablação por Cateter/métodos , Ecocardiografia Transesofagiana/métodos , Feminino , Humanos , Efeitos Adversos de Longa Duração/diagnóstico , Efeitos Adversos de Longa Duração/cirurgia , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Avaliação de Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgia , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/cirurgia , Estudos Retrospectivos , Estenose de Veia Pulmonar/diagnóstico , Estenose de Veia Pulmonar/etiologia , Estenose de Veia Pulmonar/cirurgia
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