Journal of Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2433-1783 Print ISSN: 2433-2720
Japanese Society of Pediatric Cardiology and Cardiac Surgery
Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Journal of Pediatric Cardiology and Cardiac Surgery 3(1): 35-38 (2019)
doi:10.24509/jpccs.190106

Case ReportCase Report

Effectiveness of Lobectomy in a Pediatric Patient with Pulmonary Hemorrhage and Hemoptysis Due to Pulmonary Vein Restenosis after Congenital Pulmonary Vein Stenosis Repair

1Department of Pediatrics, Jichi Children’s Medical Center Tochigi ◇ Tochigi, Japan

2Department of Pediatric Surgery, Jichi Children’s Medical Center Tochigi ◇ Tochigi, Japan

3Department of Pediatric Cardiovascular Surgery, Jichi Children’s Medical Center Tochigi ◇ Tochigi, Japan

受付日:2018年1月31日Received: January 31, 2018
受理日:2018年11月13日Accepted: November 13, 2018
発行日:2019年1月31日Published: January 31, 2019
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Congenital pulmonary vein stenosis (CPVS) is extremely rare, accounting for 0.03% of cases of congenital heart disease. The prognosis of CPVS is poor because the secondary pulmonary hypertension (PH) is progressive. Treatments options include surgical repair using a sutureless technique and stent implantation; however, the stenosis often recurs. Herein, a boy with a partial anomalous pulmonary venous connection was treated for CPVS using a sutureless technique at the age of 1 year old; however, the stenosis recurred, and he experienced repeated hemoptysis from the age of 2 years and 8 months. Because of the severity of his condition, surgery or a catheter intervention would have been challenging, and the bleeding points could not be identified. After detailed investigation using cardiac catheterization and three-dimensional computed tomography, a partial resection of the lower lobe of the right lung was performed, and hemoptysis was resolved. Compensatory enlargement of the remaining lobes maintained the patient’s respiratory function with no mediastinal shift. There was no evidence of hemoptysis during 5 years following the lobectomy, and he goes to school without exercise restrictions. Because lung transplantation is not a viable treatment option in Japan, lobectomy may become a therapeutic option for a pulmonary hemorrhage caused by restenosis of the pulmonary vein after CPVS repair using a sutureless technique.

Key words: congenital pulmonary vein stenosis; pulmonary hypertension; pulmonary hemorrhage; lung lobectomy

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