Pulmonary vein stenosis with collateralization via esophageal varices: Long‐term follow‐up after successful treatment with drug‐eluting stent |
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| Authors: | Jason F. Goldberg MD Craig L. Jensen MD Rajesh Krishnamurthy MD Nidhy P. Varghese MD Henri Justino MD CM FRCPC FSCAI |
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| Affiliation: | 1. Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA;2. Gastroenterology Section, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA;3. Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA;4. Pulmonary Section, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA |
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| Abstract: | Objective We describe the long‐term follow‐up of a child with recurrent hemoptysis due to severe pulmonary vein stenosis decompressing via collaterals to esophageal varices. Design Case report Setting Tertiary children's hospital Patient Single child through ages 2‐ to 11‐year old Interventions The child underwent cutting balloon angioplasty, bare metal stenting, and implantation of a PTFE‐covered stent, all of which failed rapidly. Only after placement of a paclitaxel drug eluting stent did he have prolonged relief from hemoptysis and long‐term patency of the treated vein. The stents were serially dilated to keep up with somatic growth of the child, eventually culminating in the need to induce intentional stent fracture. Conclusions We highlight novel transcatheter techniques to treat this vexing condition, discuss mechanisms of disease treatment and progression, and present the only patient with this rare combination of lesions to have achieved both longstanding pulmonary vein patency and resolution of esophageal varices. |
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| Keywords: | drug eluting stent esophageal varives pulmonary hypertension pulmonary vein stenosis |
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