PMC7403928_01
Computed tomography: (a) left pleural effusion (arrow); (b) consolidation and GGO in LUL (arrow). GGO: ground glass opacity; LUL: left upper lobe.
CRIPU2020-2357846.001.jpg
PMC7403928_01_CRIPU2020-2357846.001.jpg
fig1
He underwent computed tomography pulmonary angiogram (CTPA), which showed multiple patches of consolidation as well as ground glass opacities in the left upper lobe and lingula with minimal left pleural effusion, as shown in Figures 1(a) and 1(b); differentials were either an infective process or lung infarction.
CTPA: (a) unilateral pulmonary edema with interlobular septal thickening (arrow); (b) Lt.PVsO (arrow). CTPA: computed tomography pulmonary angiogram; Lt.PVsO: left pulmonary vein occlusion.
CRIPU2020-2357846.002.jpg
PMC7403928_01_CRIPU2020-2357846.002.jpg
fig2
Therefore, a contrast-enhanced CTPA was performed that showed features of unilateral left pulmonary venous congestion, and the left superior and inferior pulmonary veins were not visualized (as shown in Figures 2(a) and 2(b)), both signifying occlusion, most likely due to the prior ablation.
Three-dimensional cardiac CT reconstruction images: absent of left pulmonary veins following AF ablation (red arrow). CT: computed tomography; Ao: aorta (blue arrow); LA Ap: left atrial appendage (green arrow); LA: left atrium (yellow arrow); RSPV: right superior pulmonary vein (brown arrow); RIPV: right inferior pulmonary vein (white arrow); AF: atrial fibrillation.
CRIPU2020-2357846.003.jpg
PMC7403928_01_CRIPU2020-2357846.003.jpg
fig3
In addition to that, he also underwent a coronary CTA which revealed that the right superior and inferior pulmonary veins are well-opacified with contrast; however, both left superior and inferior pulmonary veins are not visualized in the arterial phase (as shown in Figure 3).
Absent perfusion in the left lung field in all perfusion views; in ventilation images, there is adequate ventilation of the left lung which is lower compared to the right lung.
CRIPU2020-2357846.004.jpg
PMC7403928_01_CRIPU2020-2357846.004.jpg
fig4
In the ventilation images, there was adequate ventilation of the left lung, though it was lower compared to the right lung (as shown in Figure 4).