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Objective <p>Pulmonary vein stenosis is a rare but serious complication following catheter ablation for atrial fibrillation. This study aimed to evaluate the mid-term outcomes of the sutureless marsupialization technique for acquired pulmonary vein stenosis or pulmonary vein occlusion.</p> Methods <p>Between 2006 and 2024, six patients (mean age: 54.5 ± 9.0&#xa0;years) with severe pulmonary vein stenosis or pulmonary vein occlusion after catheter ablation underwent surgical repair using the sutureless marsupialization technique. This approach avoids direct suturing to the pulmonary vein wall by covering the opened vein with autologous or xenogeneic tissue (left atrial appendage, pericardium, or atrial wall). A total of 13 pulmonary veins were reconstructed. Restenosis was evaluated using follow-up computed tomography, and 5-year patency was estimated by Kaplan–Meier analysis.</p> Results <p>All patients underwent successful repair without perioperative complications. Covering materials included the left atrial appendage (n = 3), bovine pericardium (n = 2), autologous pericardium (n = 1), and atrial wall flap (n = 1). During a mean follow-up of 62.5 ± 46.5&#xa0;months, restenosis occurred in 2 of 13 veins (15.4%) four months after surgery, both initially classified as stenotic lesions. All patients remained asymptomatic and required no further intervention. The 5-year patency rate was 84.6%.</p> Conclusions <p>The sutureless marsupialization technique offers good mid-term outcomes for acquired pulmonary vein stenosis and pulmonary vein occlusion after catheter ablation. By avoiding direct vein wall suturing, this approach may reduce restenosis. These results support its potential as a surgical option in selected patients with this rare complication.</p>

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Mid-term outcomes of the sutureless marsupialization technique for acquired pulmonary vein stenosis and occlusion

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月13日

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  • Hironari Shibahara,
  • Hideki Ito,
  • Shinichi Ashida,
  • Tomo Yoshizumi,
  • Sachie Terazawa,
  • Yoshiyuki Tokuda,
  • Yuji Narita,
  • Hajime Sakurai,
  • Masato Mutsuga

摘要

Objective

Pulmonary vein stenosis is a rare but serious complication following catheter ablation for atrial fibrillation. This study aimed to evaluate the mid-term outcomes of the sutureless marsupialization technique for acquired pulmonary vein stenosis or pulmonary vein occlusion.

Methods

Between 2006 and 2024, six patients (mean age: 54.5 ± 9.0 years) with severe pulmonary vein stenosis or pulmonary vein occlusion after catheter ablation underwent surgical repair using the sutureless marsupialization technique. This approach avoids direct suturing to the pulmonary vein wall by covering the opened vein with autologous or xenogeneic tissue (left atrial appendage, pericardium, or atrial wall). A total of 13 pulmonary veins were reconstructed. Restenosis was evaluated using follow-up computed tomography, and 5-year patency was estimated by Kaplan–Meier analysis.

Results

All patients underwent successful repair without perioperative complications. Covering materials included the left atrial appendage (n = 3), bovine pericardium (n = 2), autologous pericardium (n = 1), and atrial wall flap (n = 1). During a mean follow-up of 62.5 ± 46.5 months, restenosis occurred in 2 of 13 veins (15.4%) four months after surgery, both initially classified as stenotic lesions. All patients remained asymptomatic and required no further intervention. The 5-year patency rate was 84.6%.

Conclusions

The sutureless marsupialization technique offers good mid-term outcomes for acquired pulmonary vein stenosis and pulmonary vein occlusion after catheter ablation. By avoiding direct vein wall suturing, this approach may reduce restenosis. These results support its potential as a surgical option in selected patients with this rare complication.