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Fatal Hemoptysis Secondary to Severe Pulmonary Veins Stenosis and Fibrosing Mediastinitis following Radiofrequency Ablation for Atrial Fibrillation: A Case Report and Review of the Literature
Burduloi, V.M.; Corciova, F.C.; Sargu, G.D.; Chistol, R.O.; Rusu, A.C.; Stan, C.I. Fatal Hemoptysis Secondary to Severe Pulmonary Veins Stenosis and Fibrosing Mediastinitis following Radiofrequency Ablation for Atrial Fibrillation: A Case Report and Review of the Literature. Reports2024, 7, 2.
Burduloi, V.M.; Corciova, F.C.; Sargu, G.D.; Chistol, R.O.; Rusu, A.C.; Stan, C.I. Fatal Hemoptysis Secondary to Severe Pulmonary Veins Stenosis and Fibrosing Mediastinitis following Radiofrequency Ablation for Atrial Fibrillation: A Case Report and Review of the Literature. Reports 2024, 7, 2.
Burduloi, V.M.; Corciova, F.C.; Sargu, G.D.; Chistol, R.O.; Rusu, A.C.; Stan, C.I. Fatal Hemoptysis Secondary to Severe Pulmonary Veins Stenosis and Fibrosing Mediastinitis following Radiofrequency Ablation for Atrial Fibrillation: A Case Report and Review of the Literature. Reports2024, 7, 2.
Burduloi, V.M.; Corciova, F.C.; Sargu, G.D.; Chistol, R.O.; Rusu, A.C.; Stan, C.I. Fatal Hemoptysis Secondary to Severe Pulmonary Veins Stenosis and Fibrosing Mediastinitis following Radiofrequency Ablation for Atrial Fibrillation: A Case Report and Review of the Literature. Reports 2024, 7, 2.
Abstract
Fatal hemoptysis secondary to severe pulmonary veins stenosis is an exceptional late complication of radiofrequency ablation for atrial fibrillation. We report the case of a 53-year-old male with a history of atrial fibrillation treated by radiofrequency ablation and admitted in our center 6 months after the initial procedure because of aggravating dyspnea and fatigability. Transthoracic echocardiography showed moderate dilation of right heart cavities, severe pulmonary hypertension, and a turbulent flow in superior pulmonary veins. The cardiologist suspected pulmonary vein(s) stenosis and cardiac computed tomography (CT) angiography was performed with findings of severe stenosis of the right superior, right inferior and left inferior pulmonary veins, near-occlusion of the left superior pulmonary vein and the vein draining the apical segment of the right lower lobe. The CT scan also revealed soft tissue attenuation of the mediastinum posterior to the left atrium suggesting fibrosing mediastinitis together with parenchymal findings consistent with pulmonary venooclusive disease and an area of hemorrhagic infarction. Fatal hemoptysis occurred 3 days after the evaluation before any treatment was attempted. In conclusion, severe pulmonary stenosis remains a rare but severe complication of radiofrequency ablation. Prevention is the key element together with an early diagnosis as the entity is potentially life-threatening.
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
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