Double Trouble : Percutaneous Disobstruction of 2 Pulmonary Veins Following Catheter Ablation for Atrial Fibrillation

A 54-year-old man, who had previously undergone 2 radiofrequency catheter ablations of the pulmonary veins for recurrent atrial fibrillation, came to our attention for dyspnea. A chest x-ray showed left pleural effusion and a subsequent computed tomography scan with contrast medium revealed occlusion of both the superior and inferior left pulmonary veins. In addition, a lung perfusion scan demonstrated that the left lung was completely excluded. On the basis of these data, it was decided to attempt to disobstruct the veins percutaneously. Various therapeutic strategies have been proposed, ranging from percutaneous intervention to pulmonary lobectomy and surgical repair with pulmonary homograft tissue