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Case Reports in Cardiology
Volume 2016, Article ID 4979182, 4 pages
Case Report

Asymptomatic Pulmonary Vein Stenosis: Hemodynamic Adaptation and Successful Ablation

1University of Miami at Holy Cross Hospital, Fort Lauderdale, FL, USA
2South Florida Multispecialty Associates, LLC, Miami Beach, FL, USA
3Holy Cross Hospital, Fort Lauderdale, FL, USA

Received 15 August 2016; Accepted 4 December 2016

Academic Editor: Christian Machado

Copyright © 2016 John J. Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Pulmonary vein stenosis is a well-established possible complication following an atrial fibrillation ablation of pulmonary veins. Symptoms of pulmonary vein stenosis range from asymptomatic to severe exertional dyspnea. The number of asymptomatic patients with pulmonary vein stenosis is greater than originally estimated; moreover, only about 22% of severe pulmonary vein stenosis requires intervention. We present a patient with severe postatrial fibrillation (AF) ablation pulmonary vein (PV) stenosis, which was seen on multiple imaging modalities including cardiac computed tomography (CT) angiogram, lung perfusion scan, and pulmonary angiogram. This patient did not have any pulmonary symptoms. Hemodynamic changes within a stenosed pulmonary vein might not reflect the clinical severity of the obstruction if redistribution of pulmonary artery flow occurs. Our patient had an abnormal lung perfusion and ventilation (V/Q) scan, suggesting pulmonary artery blood flow redistribution. The patient ultimately underwent safe repeat atrial fibrillation ablation with successful elimination of arrhythmia.