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Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat
08:34

Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat

Published on: November 18, 2018

Management of congenital and acquired pulmonary vein stenosis

Eric J Devaney1, Andrew C Chang, Richard G Ohye

  • 1Division of Pediatric Cardiac Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan, USA. edevaney@umich.edu

The Annals of Thoracic Surgery
|February 21, 2006
PubMed

Insights

Pulmonary vein stenosis has a poor prognosis. Sutureless pericardial marsupialization showed better midterm results for congenital and acquired cases compared to other techniques.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Thoracic Surgery

Background:

  • Pulmonary vein (PV) stenosis, whether congenital or post-repair of total anomalous pulmonary venous connection (TAPVC), presents a significant challenge with a poor prognosis.
  • Despite advances, managing PV stenosis remains critical for improving patient outcomes.

Purpose of the Study:

  • To evaluate the outcomes of different surgical techniques for pulmonary vein stenosis.
  • To identify risk factors associated with poor prognosis in patients undergoing PV stenosis repair.

Main Methods:

  • A retrospective review of 36 patients who underwent PV stenosis repair between 1989 and 2003.
  • Patients were categorized by etiology (congenital vs. acquired) and surgical approach, including scar excision, primary repair, intraoperative stent placement, anastomotic revision, and sutureless pericardial marsupialization.

Main Results:

  • Congenital PV stenosis had a high mortality rate (8/14), with marsupialization showing better survival among survivors.
  • Acquired PV stenosis after TAPVC repair also had significant mortality, but marsupialization yielded better results (1 death, 10 survivors without restenosis).
  • Congenital etiology, marsupialization technique, associated defects, and disease extent were identified as risk factors for poor outcomes.

Conclusions:

  • Pulmonary vein stenosis continues to carry a guarded prognosis.
  • Sutureless pericardial marsupialization demonstrated satisfactory midterm results and appears superior to conventional techniques for PV stenosis.
  • Further research into optimal surgical strategies for PV stenosis is warranted.
Abstract

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