Apollo Hospitals, Opp.iim 154/11,bannerghatta Road. Bannerghatta Road.bangalore-560076
63662 29563
Posted on June 11, 2024
Rarest Case of Hemoptysis: Angioplasty of a Totally Occluded Right Superior Pulmonary Vein
Patient History
Age/Sex: 29-year-old male
Medical Background: The patient had undergone mitral valve repair a few months prior to the current presentation.
Current Presentation: The patient presented with multiple episodes of hemoptysis, characterized by coughing up blood-stained sputum.
Diagnostic Evaluation
Symptoms:Recurrent episodes of coughing with blood-stained sputum.
Findings: A thorough diagnostic evaluation revealed a total occlusion of the right superior pulmonary vein. This vein is crucial as it transports oxygenated blood from the lungs to the left side of the heart.
Treatment
Totally Occluded Right Upper Pulmonary Vein
Diagnostic Workup:
- Initial Evaluation: The primary step was to exclude any infectious causes of the hemoptysis.
- Key Finding: The total occlusion of the right superior pulmonary vein was identified as the root cause of the patient’s symptoms.
Chosen Intervention:
- Procedure: Angioplasty with stent placement was selected as the most appropriate intervention.
Crossing of the Pulmonary Vein with Conquest Pro Micro Catheter Assembly
Crossing of the Pulmonary Vein with Conquest Pro Micro Catheter Assembly
Procedure:
- Angioplasty: The angioplasty procedure was successfully performed on the totally occluded right superior pulmonary vein.
- Tools Used: A 7 x 18 mm stent was placed under the guidance of intravascular ultrasound.
- Imaging Technique: Intravascular ultrasound was used to guide the procedure, ensuring precise placement of the stent.
Stent deployment with 7×18mm Herculink Stent
Procedure Outcome
Results:
- Successful Deployment: The stent was successfully deployed, restoring blood flow through the previously occluded vein.
- Post-Procedure Imaging: Follow-up imaging confirmed unobstructed blood flow through the right superior pulmonary vein.
Final result
Conclusion
This rare and complex case of hemoptysis due to the total occlusion of the right superior pulmonary vein was effectively managed through angioplasty with stent placement. The successful outcome underscores the importance of precise diagnostic workup and the use of advanced imaging techniques in interventional cardiology. Dr. Girish B Navasundi and his team at Apollo Hospitals, Bengaluru, continue to set a benchmark in treating rare and challenging cardiovascular conditions.