A ruptured pulmonary arteriovenous fistula after laparoscopic operation / 中华创伤杂志(英文版)

Pulmonary arteriovenous fistula (PAVF) is a rare anomaly in the lung, and hemothorax or massive hemoptysis due to spontaneous rupture of the fistula sac is even rarer. The patient described here was a 47-year-old woman who presented with massive hemoptysis resulting from the rupture of her PAVF just after laparoscopic operation. To our knowledge, this may be the first case ever reported that the rupture of PAVF may be correlated with a laparoscopic operation. The patient survived without adverse events after emergency pulmonary lobectomy.

Development of a Pulmonary Arteriovenous Fistula after a Modified Glenn Shunt in Tetralogy of Fallot and Its Resolution after Shunt Takedown in a 57-Year-Old Patient

Pulmonary arteriovenous fistula (PAVF) is a complication of the Glenn shunt. A 57-year-old tetralogy of Fallot (TOF) patient, who had undergone a Glenn shunt and TOF total correction, complained of dyspnea and cyanosis. PAVFs were present in the right lung, and right lung perfusion was nearly absent. After coil embolization, takedown of the Glenn shunt, and reconstruction of the right pulmonary artery, the patient's symptoms were relieved. Extrapulmonary radioisotope uptake caused by the PAVFs shown in lung perfusion scans decreased, and right lung perfusion increased gradually. Although the development and resolution of PAVFs after a Glenn shunt have been reported in the pediatric population, this may be the first report on this change in old age.

Congenital pulmonary arteriovenous fistula / 中华实用儿科临床杂志

Congenital pulmonary arteriovenous fistula is a clinical rare abnormality of pulmonary vessels.The main reason is pulmonary capillary network hypoplasia.The clinical disease progression is occult.Exertional dyspnea,cyanosis and acropachy are the classical phenotypes.The key diagnosis methods include angiogram and multi-slice spiral CT angiography.The research progress of this disease was reviewed in this paper.

Cierre percutáneo de fístula arteriovenosa pulmonar en una adolescente: Reporte de un caso / Transcatheter closure of pulmonary arteriovenous fistula in adolescent: Case report

Las fístulas arteriovenosas, también llamadas malformaciones arteriovenosas pulmonares (MAVP), corresponden a un reducido grupo de patologías vasculares que en un 85% se originan de la comunicación de una arteria aferente con una vena eferente. Las congénitas son las menos frecuentes. Se presenta el caso de una adolescente de 13 años, asintomática, con soplo continuo y saturación periférica de 88%. Mediante estudios de imagen se corrobora la presencia de una fistula arteriovenosa a nivel pulmonar, que es cerrada por intervencionismo con dispositivo oclusor. Una vez tratado el defecto, la evolución de la paciente es satisfactoria. Conclusiones: Mediante el caso se abordan las herramientas clínicas y diagnósticas de las MAVP, así como las indicaciones de los modos terapéuticos.

Arteriovenous fistulas also called pulmonary arteriovenous malformations (PAVM) are a small group of vascular pathologies in 85% originate from the communication afferent efferent artery to a vein. Congenital are less frequent. The case of a 13-year-old asymptomatic continuous murmur and peripheral saturation of 88% is presented. By imaging the presence of an arteriovenous fistula in the lung, which is closed by intervention with occluder device is corroborated. Once treated the defect, the evolution of the patient is satisfactory. Conclusions: Using the case of clinical and diagnostic tools MAVP addresses, and the particulars of the therapeutic modes.

Pulmonary Arteriovenous Fistula with Hemothorax: A case report / 대한흉부외과학회지

Pulmonary arteriovenous fistula is usually considered as a subset of congenital anomalies or acquired causes which can produce a variety of conditions such as dyspnea, cyanosis, and pulmonary vascular bruit. The diagnostic methods can be diverse such as arterial blood gas analysis (ABGA), chest X-ray, chest CT and pulmonary angiogram but the most accurate diagnostic modality is thought to be the pulmonary angiogram. The complications of this disease are a rupture that can cause hemothorax, brain abscess, and cardiovascular accident, and the treatment options are either segmental resection or therapeutic embolization. A twenty-six year old female developed sudden dyspnea and visited our emergency room. The patient was diagnosed as having pulmonary arteriovenous fistula (size; 4x4x3 cm) in the superior segment of the right lower lobe, evidenced by chest CT and pulmonary angiogram. Consequently, she underwent an emergency right lower lobectomy. We report this rare case of combined hemothorax that we have experienced, from diagnosis to treatment.

A Case of Cerebral Abscess with Pulmonary Arteriovenous Fistula

Pulmonary arteriovenous fistula is an uncommon capillary abnormality. It may be accompanied by neurological complications such as cerebral abscess and be associated with or without hemorrhagic telangiectasia. We recently experienced a case of cerebral abscess with pulmonary arteriovenous fistula(PAVF), which was not associated with hereditary hemorrhagic telangiectasia. We report this case with review of the related literature.

Pulmonary Arteriovenous Fistula presented by Brain Abscess: A case report / 대한흉부외과학회지

Pulmonary arteriovenous malformations(PAVM) are uncommon diseases. Brain abscesses could be a rare and devastating complication of PAVM. Central nervous complaints may be the first manifestations of PAVM. We report a case of PAVM presented by brain abscess, which was treated by craniotomy.

Tetralogy of Fallot with Pulmonary Arteriovenous Fistula: A Case Report / 대한흉부외과학회지

Pulmonary arteriovenous fistula can occur in a variety of clinical situations including liver diseases, infections, metastatic carcinomas, systemic disorders, and after the palliation of congenital heart diseases. A 72-day-old male infant with Tetralogy of Fallot and pulmonary atresia underwent surgical correction without difficulty. However, ventilator weaning in the ICU failed initially because of an unexplained postoperative hypoxemia(FiO2: 0.8, PaO2: 40 mmHg, SaO2: 80~90%). Postoperative follow-up lung perfusin scan at postoperative 15 days showed right-to-left shunt(33.6%) and ventilator weaning was performed on the 20th day after the operation (FiO2: 0.4, PaO2, 50mmHg, SaO2: 86.9%). Arterial oxygen saturation under room air was 80~85% at 7 months postoperatively. One and half year follow-up lung perfusion scan showed decreased amount of right-to-left shunt (11.2%). We report a case with a review of the literatures.

A Case of Pulmonary Arteriovenous Fistula with Family History / 결핵

Pulmonary arteriovenous fistula is a congenital vascular malformation in lung resulting from abnormal capillary development and the exact etiology is not well known but it may occur with or without hereditary hemorrhagic telangiectasia. Hereditary hemorrhagic telangiectasia (L-IHT) or Rendu-Osler-Weber disease is an autosomal dominant vascular disorder which associates epistaxis, mucocutaneous and visceral telangicetases, and recurrent hemorrhage with chronic anemia and visceral shuntings. Recently we experienced a case of the pulmonary arteriovenous fistula in a 23 year old woman with a family history of this disease, which was confirmed by pulmonary angiography.

Systemic Pulmonary Arteriovenous Fistula: 1 Case Report / 대한흉부외과학회지

This is a case report of an operation for the pulmonary arteriovenous fistula supplied from the systemic arteries instead of the pulmonary artery. The operation of systemic arteriovenous pulmonary fistula has formidable technical challenges due to its extensive collateral circulations. A 16 year-old female patient, diagnosed as systemic arteriovenous fistula with multiple tortuous feeding vessels and with hereditary hemorrhagic telangiectasia, was initially managed with arterial embolization before the operation. A 15x8cm sized huge vascular malformation was removed by RML and RLL bilobectomy. During the operation, we encountered annoying massive bleeding and pulmonary congestion originated in its extensive collateral circulation. The patient was discharged after conservative management without specific problem on the 15th postoperative day. For the safe operation as well as good operative result, it seemed that meticulous ligation of the multiple collateral vessels should be performed prior to that of pulmonary veins.

Treatment of Multiple Pulmonary Arteriovenous Fistulas with Therapeutic Embolization in Osler-Rendu-Weber Syndrome / 결핵

Hereditary hemorrhagic telangiectasia(Osler-Rendu-Weber Syndrome) is characterized by telangiectasia of the skin and mucous membranes and intermittent bleeding from vascular abnormalities. About 20% of patients with this is syndrome have pulmonary arteriovenous fistulas. Pulmonary arteriovenous fistula is uncommon malformation which has an abnormal connection between the pulmonary capillary bed, in which venous blind in the pulmonary artery is shunted through the fistula into the pulmonary vein without exposure to alveolar oxygen and result in unoxygenated, desaturated systemic arterial blood, polycythemia, cyanosis and clubbing. Death often results from cerebral abscess and rupture of the malformation with massive hemorrhage. Therapeutic intervention is recommended for all symptomatic patients because of the risk of those serious complications. Treatment options include surgery and transcatheter obliteration with steel coils or detachable balloons. Therapeutic embolization has the advantages that multiple bilateral pulmonary arteriovenous fistulas can be occluded and also that the procedure can be repeated if necessary. Recently we experienced a case of the multiple bilateral pulmonary arteriovenous fistulas associated with telangiectatic change of hepatic artery and multiple angiodysplasia on the gastric mucosa in 41 years old female patient who had mild dyspnea of exertion(NYHA class II), clubbing finger, severe iron deficiency anemia. She was treated with embolization technique using steel coils and iron replacement. After the therapeutic embolization, significant improvement of dyspnea of exertion with disappearance of multiple pulmonary nodule on follow-up simple chest x-ray was noted. During the subsequent six months follow-up period, she bad the improvement of symptoms arid iron deficiency anemia.

Imaging Diagnosis and Endovascular Treatment of Congenial Pulmonary Arteriovenous Fistulas / 医疗卫生装备

Objective To analyze the imaging manifestation and feature of congenial pulmonary arteriovenous fistulas (CPAVF) and observe the effect of endovascular treatment. Methods The plain films, CT and DSA of CPAVF retrospective- ly were analyzed. The effect of transcatheter embolization with coil was observed by follow-up. Results Feeding artery was pulmonary artery branches in five cases and was branchial artery in one case. The images of all cases were divided into three types: simple type-3 cases, complex type-2 cases and diffuse type-1 case. Both CT and DSA could give the correct diagnosis, however 3 cases were diagnosed wrongly by X-ray. Three cases were underwent transcatheter endovascular em- bolism with coils, and one case were done three times. Systemic arterial oxygen saturation improved strikingly in two pa- tients after treatment, and the symptoms of hemoptsis disappeared immediately after branchial arterial embolism in other case. Conclusion DSA was the best means in the diagnosis of PAVF. CT and three-dimensional reconstruction can be giv- en correct and direct diagnosis for big PAVF, but can not replace DSA in the diagnosis of small PAVF. Percutaneous tran- scatheter endovascular embolism with coils is an effective and safe treatment for PAVF, but it is only a palliative therapy for diffuse PAVF.