Adjunctive vein of marshall ethanol infusion for pulmonary vein isolation in unilateral left pulmonary artery agenesis: a case report

In UAPA, extensive systemic collateral circulation to the affected lung may cause heat dissipation ('heat sink effect'), limiting the efficacy of thermal energy delivery. Moreover, hypoplastic PVs carry an increased risk of stenosis after thermal ablation. Additional non-thermal lesion-creation techniques, such as VOM ethanol infusion, may be necessary to achieve durable and safe isolation when conventional thermal methods are insufficient.