Pathogenesis, Evaluation, and Management of Pulmonary Vein Stenosis: JACC Review Topic of the Week

Trevor Simard; Dhruv Sarma; William R Miranda; C Charles Jain; Jason H Anderson; Jeremy D Collins; Abdallah El Sabbagh; Aravdeep Jhand; Tobias Peikert; Guy S Reeder; Thomas M Munger; Douglas L Packer; David R Holmes

doi:10.1016/j.jacc.2023.04.016

Pathogenesis, Evaluation, and Management of Pulmonary Vein Stenosis: JACC Review Topic of the Week

J Am Coll Cardiol. 2023 Jun 20;81(24):2361-2373. doi: 10.1016/j.jacc.2023.04.016.

Affiliations

¹ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: https://twitter.com/tjsimard.
² Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: https://twitter.com/SarmaDhruv.
³ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
⁴ Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
⁵ Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA.
⁶ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
⁷ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: [email protected].

PMID: 37316116
DOI: 10.1016/j.jacc.2023.04.016

Abstract

Pulmonary vein stenosis (PVS) can arise from several etiologies, including congenital, acquired, and iatrogenic sources. PVS presents insidiously, leading to significant delays in diagnosis. A high index of suspicion and dedicated noninvasive evaluation are key to diagnosis. Once diagnosed, both noninvasive and invasive evaluation may afford further insights into the relative contribution of PVS to symptoms. Treatment of underlying reversible pathologies coupled with transcatheter balloon angioplasty and stenting for persistent severe stenoses are established approaches. Ongoing refinements in diagnostic modalities, interventional approaches, postintervention monitoring, and medical therapies hold promise to further improve patient outcomes.

Keywords: atrial fibrillation ablation; fibrosing mediastinitis; pulmonary vein intervention; pulmonary vein isolation; pulmonary vein stenosis.

Publication types

Review

MeSH terms

Angioplasty, Balloon*
Constriction, Pathologic / diagnosis
Constriction, Pathologic / etiology
Constriction, Pathologic / therapy
Humans
Stenosis, Pulmonary Vein* / diagnosis
Stenosis, Pulmonary Vein* / etiology
Stenosis, Pulmonary Vein* / therapy
Stents