[Pulmonary arterio-venous fistula cases in Shaheed Rajayee Heart Hospital during 30 years [1974 - 2003]]

ABSTRACT

Pulmonary arteriovenous fistula [PAVF] is a rare cyanotic disease. Until 1942 when the first surgery was performed for PAVF, there was not any treatment option available for this disease. In 1977, the first embolotherapy for PAVF was carried out and today, this procedure is the treatment of choice for PAVF. There has been no report of PAVF patients from Iran so far. In a retrospective study, all PAVF cases who had been hospitalized since the inauguration of the center were identified, and data regarding demographic information, symptoms, signs, complications, paraclinical studies, treatment complications and results, and long-term follow-up were gathered and analyzed. Our patients comprised 11 cases and had a lower mean age [16 years] compared with previous large studies. We found that the lower referral rate of non-Tehranian adult patients to our center, as compared to non-Tehranian pediatric patients, might have been responsible for the observed difference. Other statistically significant differences were lower prevalence of chronic headaches [9%] and higher rate of polycythemia [70%] in our patients compared with other studies. The first PAVF surgery had been performed in 1991 and the first embolotherapy in 2001 at our center. After 2001, no PAVF patient had been referred for fistula surgery. PAVF is a rare and interesting disease. Embolization has opened new horizons into the treatment of PAVF