[III-JCKAP7-2-4] Pulmonary Vein Stenting in Patient with Hypoplasia of Pulmonary Vein
Keywords:Pulmonary vein stenosis, Stenting, Hemoptysis
Introduction: We describe a rare case of left unilateral pulmonary vein atresia (PVA) as the underlying etiology of recurrent hemoptysis in a child. In a right lung, pulmonary vein (PV) was stenosis combined with pulmonary hypertension. The effort to right pulmonary vein stenting can reduce hemoptysis. Case summary: A 14-month-old boy was referred to our hospital for recurrent hemoptysis. Diagnosis of left unilateral PVA was suspected on echocardiography which demonstrated pulmonary artery hypertension and small to atresia of RPV. The angiography revealed hypoplasia of total left PV. Almost blood flow to right lung and return to left atrium through right pulmonary vein (RPV), but ostium of RPV was severe stenosis with pre-stenotic dilation of RPV. Pressure gradient between PV and LA was 22 mmHg and pulmonary artery pressure was 50 mmHg. Our strategy is to stent the ostium of RPV through atrial septum puncture. This treatment was consisted of atrial septum puncture by 0.014'' wire, further dilation to introduce large sheath to left atrium and a renal stent 7.0 x 16 mm was implanted in the ostium of RPV. The patients was improved clinically and hemoptysis was reduced after pulmonary vein stenting.Conclusion: Abnormal of PV should be considered and investigated for recurrent hemoptysis in children. Catheterization angiography could be useful tool to establish the diagnosis of PVA and prompt treatment when combined with contralateral PV stenosis. The patient should be follow-up for hemoptysis and other treatment approach will be consider if persistence of hemoptysis.