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Updated: Apr 12, 2026
Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Outcomes and Patency After Surgical Repair of Previously Stented Pulmonary Veins in Pediatric Patients
Allison Beckham Davila1, Mariana Chavez2, Kimberlee Gauvreau3
1Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Cardiac Surgery, Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Chicago, Illinois.
Insights
Pulmonary vein (PV) stent interventions for pulmonary vein stenosis (PVS) are increasing. Surgical repair outcomes show 84% of stented veins remain patent, with no significant difference in survival for patients with or without prior stents.
Area of Science:
- Cardiology
- Interventional Cardiology
- Thoracic Surgery
Background:
- Pulmonary vein stenosis (PVS) is a complex condition often requiring intervention.
- Catheter-based pulmonary vein (PV) stents are increasingly used for severe recurrent PVS.
- Surgical repair of PVS following stent implantation presents unique challenges.
Purpose of the Study:
- To evaluate surgical outcomes in patients undergoing pulmonary vein stenosis (PVS) repair after prior pulmonary vein (PV) stent implantation.
- To assess the patency rates and survival in this specific patient cohort.
- To compare outcomes between patients with and without prior PV stents.
Main Methods:
- Retrospective review of a PVS registry from a single center (September 2007 - July 2023).
- Identification of patients who had prior PV stents, developed in-stent stenosis, and required surgical PVS repair.
- Analysis of clinical data including follow-up, reinterventions, and survival rates.
Main Results:
- Out of 251 patients undergoing PVS repair, 42 (17%) had prior PV stents.
- Median follow-up was 8 months; 74% required post-operative catheter reintervention.
- Overall survival at discharge was 95%, with 65% survival at last follow-up. 84% of stented veins remained patent.
- No significant difference in survival was observed between patients with and without prior stents (p=0.23).
Conclusions:
- Catheter-based PV stent interventions for severe recurrent PVS are on the rise.
- Surgical repair of PVS in stented veins demonstrates promising patency rates (84%).
- Prior stent placement does not appear to negatively impact survival outcomes after surgical PVS repair.
Background:
The study objective was to evaluate surgical outcomes of patients having had catheter-based pulmonary vein (PV) stents implanted with subsequent pulmonary vein stenosis (PVS) repair in a large, single-center cohort.
Methods:
Clinical data were retrospectively reviewed from a PVS registry identifying patients who had prior PV stents placed, had in-stent stenosis, and required subsequent PVS repair.
Results:
Between September 2007 and July 2023, 251 patients underwent surgical PVS repair, of whom 42 (17%) had prior PV stents implanted. Bilateral stents were present in 19 patients (45%). Thirty-one patients (74%) had at least 1 prior PV operation. Median follow-up was 8 months (interquartile range, 3-36 months). Thirty-one patients (74%) underwent postoperative catheter reintervention to maintain patency, and 6 patients (14%) underwent surgical reoperation. Overall, survival at discharge was 95%, and in the modern era, 65% survived at last follow-up. There were similar survival outcomes in PVS patients undergoing surgery with and without prior stents (P = .23). Of the individual veins in patients with prior stents, 84% (n = 97) of stented veins were patent at last follow-up.
Conclusions:
Increasing numbers of patients are undergoing catheter-based PV stent interventions for severe recurrent PVS. Despite this, there are reasons to be hopeful, with 84% of these veins patent at most recent follow-up, and no difference in survival of patients with or without preoperative stent placement.
