CTICasesPulmonary vein occlusion post-radiofrequency ablation causing bronchial venous engorgement
Imaging findings
Chest CT shows complete occlusion of the left superior and left inferior pulmonary veins in a patient with a history of radiofrequency catheter ablations for atrial fibrillation. Bronchoscopy reveals marked engorgement and dilation of the submucosal bronchial veins within the distal trachea and left main bronchus.
Key takeaways
Occlusion of the pulmonary veins is a known complication of radiofrequency catheter ablation for atrial fibrillation. This causes pulmonary venous hypertension and leads to compensatory collateral flow through deep bronchial veins, manifesting as bloodshot, engorged submucosal bronchial vessels on bronchoscopy and presenting as recurrent hemoptysis.
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