Digital Subtraction Dynamic Pulmonary Angiography Demonstrating Pulmonary Vein Stenosis

Video Supplement to “Pulmonary Arteriography in Pulmonary Vein Stenosis,” by Duque, et al. (May 2020 Clinical Images).

A 43-year-old woman underwent radiofrequency pulmonary vein ablation for symptomatic paroxysmal atrial fibrillation. Three months later, she developed worsening dyspnea and exercise intolerance. The following digital subtraction dynamic pulmonary angiography showed a marked delay in the pulmonary capillary filling time, and in the left inferior pulmonary lobe there was no capillary filling with the contrast medium and an absence of venous return to the left atrium. The left superior PV was clearly seen in the final phase of the angiography, ruling out thrombosis. The right superior and right inferior PVs had severe stenosis at the venoatrial junction with an abnormally small left atrium.

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