# Thoracoscopic pneumonectomy for massive haemoptysis secondary to chronic pulmonary vein stenosis post-atrial fibrillation ablation

## TL;DR

A man developed severe lung bleeding due to a rare complication after heart ablation surgery and required lung removal to resolve it.

## Contribution

This case highlights the need for anatomical pulmonary resection in managing late-onset massive haemoptysis due to chronic pulmonary vein stenosis.

## Key findings

- A 57-year-old man with chronic PV stenosis required left pneumonectomy after 18 months of post-ablation complications.
- Pathological findings showed irreversible fibrosis of the PV intima leading to pulmonary congestion.
- Surgical intervention successfully resolved the haemoptysis caused by long-term PV stenosis.

## Abstract

Pulmonary vein (PV) stenosis is a rare but serious complication after transcatheter ablation for atrial fibrillation, potentially leading to massive haemoptysis. We present a case of severe PV stenosis resulting in haemoptysis. A 57-year-old man presented with haemoptysis 18 months after catheter ablation. His left PV was almost completely occluded and required the left pneumonectomy. Pathological examination revealed irreversible fibrosis of the PV intima, which led to pulmonary congestion. Surgical intervention resolved the haemoptysis. Anatomical pulmonary resection is required for massive haemoptysis caused by PV stenosis that occurs long after transcatheter ablation.

Transcatheter ablation is a common and effective therapeutic strategy for atrial fibrillation.