Open Access

ARTICLE

Pulmonary vein stenosis with collateralization via esophageal varices: Long-term follow-up after successful treatment with drug-eluting stent

Jason F. Goldberg¹, Craig L. Jensen², Rajesh Krishnamurthy³, Nidhy P. Varghese⁴, Henri Justino¹

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

* Corresponding Author: Henri Justino MD, Texas Children’s Hospital, 6621 Fannin St. MC 19345-C, Houston, TX 77030. Email:

Congenital Heart Disease 2018, 13(1), 124-130. https://doi.org/10.1111/chd.12537

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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