# Surgical and Catheter-Based Intervention in Pediatric Pulmonary Vein Stenosis — GCMD Library

Lizzie Lee from Cincinnati Children's discusses a study on pediatric pulmonary vein stenosis (PVS), a rare but serious condition. The research compares surgical and catheter-based interventions, revealing high recurrence rates for both approaches. It emphasizes the need for ongoing surveillance and multidisciplinary care for affected children.

Daiji Takajo, Paul J Critser, Awais Ashfaq, Russel Hirsch

Background: Pulmonary vein stenosis (PVS) is a rare but serious condition in children, often requiring surgical or catheter-based interventions. The initial optimal treatment strategy remains unclear due to disease complexity, progression, and high rates of recurrence.

Methods: In this retrospective, single-center study, we identified children with primary or secondary PVS from a cardiac catheterization and surgical database between 2015 and 2023. Patients with single ventricle physiology were excluded. Demographics and outcomes were compared between patients who underwent catheter-based intervention only and those who underwent at least one surgical pulmonary vein repair, with or without subsequent catheter-based reintervention. Reintervention following surgical repair was assessed using Kaplan-Meier analysis.

Results: Among 56 children with biventricular physiology and PVS (33 males, 59%), 16 (29%) underwent at least one surgical repair at a median age of 9 months (IQR 4-20), while 40 (71%) were managed with catheter-based interventions alone. Surgical repair was more frequently performed in patients with bilateral or complex disease, particularly those without prematurity or with coexisting congenital heart defects requiring open-heart surgery. Over time, catheter-based approaches became increasingly preferred. Overall, 92% of surgical patients required reintervention, most within the first year. Mortality did not significantly differ between groups (p = 0.294). In the surgical group, elevated right ventricular/systemic systolic pressure ratio (HR: 1.25, p = 0.048) and the presence of scimitar syndrome (HR: 8.25, p = 0.011) were associated with increased mortality.

Conclusions: Surgical pulmonary vein repair remains an important option, particularly in cases where catheter-based intervention is not feasible due to anatomical challenges or when multiple pulmonary veins are severely affected. However, recurrent pulmonary vein re-intervention is common, regardless of whether the initial approach was surgical or catheter-based.

https://pubmed.ncbi.nlm.nih.gov/41995823/

Type: video · 0 min · posted 2026-07-09
Canonical: https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566

## Chapters
- [0:00](https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566?t=0) Surgical vs Catheter-Based Intervention in Pediatric Pulmonary Vein Stenosis

## Statements
- "Pulmonary vein stenosis is a rare but serious condition where the veins from the lungs to the heart become narrowed" — Lizzie Lee (clinical) [0:06](https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566?t=6)
- "A study from Cincinnati Children's examined 56 children comparing surgery versus catheter-based interventions for pulmonary vein stenosis" — Lizzie Lee (epidemiological) [0:12](https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566?t=12)
- "Over time, catheter-based treatments became the preferred first option for pulmonary vein stenosis" — Lizzie Lee (clinical) [0:23](https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566?t=23)
- "Surgery was reserved for complex cases involving multiple severely affected veins or other heart defects" — Lizzie Lee (clinical) [0:28](https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566?t=28)
- "92% of children with pulmonary vein stenosis needed another intervention after initial treatment" — Lizzie Lee (epidemiological) [0:34](https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566?t=34)
- "Most reinterventions for pulmonary vein stenosis occurred within the first year after initial treatment" — Lizzie Lee (epidemiological) [0:34](https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566?t=34)
- "Recurrence of pulmonary vein stenosis remained common regardless of the initial intervention type" — Lizzie Lee (clinical) [0:34](https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566?t=34)
- "Pulmonary vein stenosis requires ongoing surveillance, repeated interventions, and a long-term multidisciplinary approach" — Lizzie Lee (clinical) [0:48](https://library.globalcastmd.com/watch/surgical-and-catheter-based-intervention-in-pediatric-pulmonary-vein-stenosis-13566?t=48)

## Transcript
Can you ever truly fix pulmonary vein stenosis? I'm Lizzie Lee, and this is an article you should know about from Cincinnati Children's. Pulmonary vein stenosis is a rare but serious condition where the veins from the lungs to the heart become narrowed. Researchers looked at 56 children and compared two different approaches, surgery versus catheter-based interventions. They wanted to know which approach is. Better to prevent recurrence. So what did they find? Over time, catheter-based treatments became the preferred first option to try. Surgery was reserved for complex cases involving multiple severely affected veins or other heart defects. Within the first year after intervention, 92% of the kids needed another intervention later on, most within the first year, and recurrence remained common regardless of the initial intervention. So pulmonary vein stenosis isn't a one-time fix. It requires ongoing surveillance, repeated interventions, and a long-term multidisciplinary approach to keep these children healthy. Let us know what you think in the comments below.

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Not medical advice · citation policy: https://library.globalcastmd.com/ai