[Pulmonary vein stenosis. Description of a sutureless surgical procedure using the pericardium in situ]

Pulmonary vein stenosis is a rare cardiac disease associated with a disastrous prognosis. Nowadays, it is more often a iatrogenic complication, following neonatal surgical repair of total anomalous pulmonary venous drainage (TAPVD). It is as well a native congenital anomaly. The responsible histologic lesion is an intimal hyperplasia that proliferates to involve the extracardiac segment of the pulmonary veins. This lesion tends to be extremely recurrent following surgical or angioplastic attempts. A new sutureless surgical technique, that tunelizes the pulmonary veins to the left atrium through the pericardium, is described. This method was successfully applied in a 2.5 years old child, presenting with bilateral stenosis of pulmonary veins, following neonatal repair of a TAPVD. The result, controlled 6 months later, by catheterization and angiography was judged satisfactory. This new technique, that has to be confirmed by a longer follow up, may provide a therapeutic answer to this challenging disease.