Ten-Year Experience with Pediatric Pulmonary Vein Interventions: Adverse Events and Institutional Strategies for Safety.

Abstract

Pulmonary vein stenosis (PVS) in pediatric patients is associated with significant morbidity and requires repeated transcatheter interventions to maintain pulmonary vein patency. While these procedures can improve clinical outcomes, they come with inherent risks, and data on safety and post-procedural outcomes are limited. This single-center, retrospective study included pediatric patients who underwent transcatheter interventions for PVS between 2015 and 2024. Data were collected on patient demographics, procedural details, post-procedure disposition, adverse events (AEs), and hospital length of stay. Statistical analysis was performed to identify predictors of AEs. A total of 224 catheterization procedures were performed on 67 children with PVS. The overall AE rate was 11%, with the most common events including puncture site bleeding (5 cases), followed by pulse loss (4 cases), pulmonary hemorrhage (3 cases), stent embolization (3 cases), cerebrovascular accident (2 cases), contained vascular tear of pulmonary veins (2 cases), heart block (2 cases), supraventricular tachycardia (SVT, 2 cases), intra-abdominal hemorrhage associated with transhepatic access (1 case), and ST-segment changes (1 case). Despite these risks, most patients, particularly those treated on an outpatient basis, experienced short hospital stays. Operator experience and multidisciplinary care were critical in optimizing safety and outcomes. No statistically significant predictors of AEs were identified. Percutaneous interventions for PVS can be performed safely with strict adherence to standardized protocols, allowing for a controlled rate of complications despite increasing case volumes. While serious AEs such as cerebrovascular events and pulmonary hemorrhage remain a concern, targeted strategies may contribute to improved safety outcomes.