Source: Annual Congress 2001 - Disease of the pulmonary circulation
Disease area: Pulmonary vascular diseases, Thoracic oncology

Abstract

A 43 years old male, who had a successful primary catheter ablation (2 linear lesions encircling the ostia of both upper and lower pulmonary veins) for the reason of drug refractory atrial fibrillation 6 month before was hospitalized with massive hemoptysis. Bronchoscopically an excessive central hypervascularization and diffuse bleeding was detected, suspicious for central bronchial carcinoma. Cytologically the bronchial brush specimen revealed PAP V (NSCLC). TCT showed a right central mass and enlarged bihilar and mediastinal lymphnodes. As mediastinoscopically N₂/N₃ disease could be excluded, right thoracotomy was performed exhibiting an extreme hypervascularization with venous ectasy of the hilar region. As histologically no cancer was found, the operation was finished. The postoperative histology of the resected lung specimen was typical for a veno-occlusive disease. Postoperative pulmonary angiography showed only a slight decrease of upper lobe circulation. Using transseptal approach, left atrial angiography demonstrated a totally occluded right upper pulmonary vein, which was subsequently recanalized.
Conclusion: Catheter atrial ablation may be complicated by total occlusions of pulmonary veins resp. veno-occlusive disease.

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Citations should be made in the following way:
S. Schwarz, C. Kugler, K. M. Müller, S. Ernst, K. H. Kuck, E. Kaukel (Hamburg, Germany). Pulmonary veno-occlusive disease as a consequence of catheter ablation of atrial fibrillation. Eur Respir J 2001; 16: Suppl. 31, 3514

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