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Echocardiographic Diagnosis and Management of Unexpected Pulmonary Vein Stenosis After Aortic Valve Replacement

Published:October 12, 2022DOI:https://doi.org/10.1053/j.jvca.2022.10.007
      LEFT VENTRICULAR (LV) venting cannulae are used commonly during open-chamber cardiac surgical procedures to help evacuate retained air and debris after closure of the heart chambers. In this report, the authors describe a case of iatrogenic pulmonary vein stenosis (PVS) secondary to vent insertion site suture closure. Timely echocardiographic diagnosis allowed for immediate revision of the vent insertion site closure suture and return of normal pulmonary venous flow into the left atrium. Pulmonary vein stenosis is a known complication of orthotopic lung transplantation and transcatheter ablation for atrial fibrillation,
      • Loyalka P
      • Cevik C
      • Nathan S
      • et al.
      Percutaneous stenting to treat pulmonary vein stenosis after single-lung transplantation.
      • Jing L
      • Chen W
      • Zhai Z
      • et al.
      Pulmonary vein stenosis after lung transplantation: A case report and literature review.
      • Patel NS
      • Pettersson G
      • Murat Tuzcu E
      • et al.
      Successful surgical repair of iatrogenic pulmonary vein stenosis.
      • Shroff N
      • Choi W
      • Villanueva-Meyer J
      • et al.
      Pulmonary vein occlusion: A delayed complication following radiofrequency ablation for atrial fibrillation.
      and has been reported as a postoperative finding in patients undergoing open-chamber cardiac surgery with LV venting via the right superior pulmonary vein. To the authors’ knowledge, this is the first reported case of intraoperative transesophageal echocardiographic detection of iatrogenic PVS secondary to LV venting site closure in the literature.

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