Complex, Isolated Pulmonary Arteriovenous Malformation in Two Children With Severe Cyanosis.

2021 ◽  
pp. 215013512110535
Author(s):  
Iyad AL-Ammouri ◽  
Alexander Rabadi ◽  
Sufian Abdel Hafez ◽  
Raed Al-Taher ◽  
Amjad Bani Hani ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Exercise Intolerance ◽  
Pulmonary Arteriovenous Malformation ◽  
Pulmonary Arteriovenous Malformations ◽  
Segmental Artery ◽  
Anatomical Features ◽  
Surgical Ligation

We present two cases of Isolated complex pulmonary arteriovenous malformations in two children presenting with cyanosis and exercise intolerance. We present the anatomical features and the management of each case. One patient was treated with surgical ligation of the draining vein, and one patient was treated percutaneously by closure of the feeding segmental artery.

scholarly journals Successful treatment of bilateral multiple pulmonary arteriovenous malformations in a patient with brain abscess and severe hypoxemia using a combination of transcatheter embolotherapy and surgical resection: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takahiro Ochi ◽  
Masako Chiyo ◽  
Takamasa Ito ◽  
Hideharu Furumoto ◽  
Toshihiko Sugiura ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Abscess ◽  
Surgical Resection ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteriovenous Malformation ◽  
Positive Pressure ◽  
Pulmonary Arteriovenous Malformations ◽  
Severe Hypoxemia ◽  
History Of ◽  
The Brain

Abstract Background A pulmonary arteriovenous malformation is an abnormal dilated blood vessel that makes direct communication between a pulmonary artery and pulmonary vein and can be associated with hypoxemia or neurological complications, including brain abscess and cerebral infarction. Treatment of pulmonary arteriovenous malformation includes surgical resection and transcatheter embolotherapy, however the adaptation of therapies should be considered when a patient is in bad condition. Case presentation A 51-year-old man was admitted after developing fever, consciousness disorder, and hypoxemia. Magnetic resonance imaging of the brain showed a brain abscess. Bilateral pulmonary arteriovenous malformations were found by contrast computed tomography. Because of a family history of pulmonary arteriovenous malformation, a history of epistaxis, and the existence of oral mucosa telangiectasia, he was diagnosed with hereditary hemorrhagic telangiectasia and brain abscess caused by intrapulmonary right-to-left shunt. The brain abscess improved with antibiotic treatment; however, the administration of oxygen did not ameliorate his hypoxemia. His hypoxemia was exacerbated by positive pressure ventilation. Considering his systemic and respiratory condition, we considered surgery to involve a high degree of risk. After controlling his brain abscess and pneumonia, transcatheter embolotherapy was performed. This improved his systemic condition, enabling surgical treatment. Conclusions This middle-aged patient suffering from brain abscess and severe hypoxemia with multiple pulmonary arteriovenous malformations was successfully treated by a combination of transcatheter embolotherapy and surgery. The adaptation and combination of therapies, as well as the sequence of treatments, should be considered depending on the patient status and lesions.

scholarly journals Novel Technique in the Management of a Patient With Pulmonary Arteriovenous Malformation and Biventricular Non Compaction

2021 ◽  
Author(s):  
Desabandhu Vinayakumar ◽  
Gopalan Nair Rajesh ◽  
Haridasan Vellani ◽  
Jomy Vadasseril Jose
Keyword(s):  
Arteriovenous Malformation ◽  
Patent Foramen Ovale ◽  
Arteriovenous Malformations ◽  
Right Ventricular Dysfunction ◽  
Pulmonary Arteriovenous Malformation ◽  
Pulmonary Arteriovenous Malformations ◽  
Foramen Ovale ◽  
Device Closure ◽  
Novel Technique ◽  
Primary Treatment Modality

Abstract Background: Transcatheter device closure has become the primary treatment modality for pulmonary arteriovenous malformations. When compared to lobectomy or vessel ligation, this approach is much less destructive and allows for selective closure of the arteriovenous malformation while preserving the normal branching vessels and lung parenchyma. But, often the procedure is cumbersome due to anatomical and procedural factors. Case Presentation: We report the case of a 19 year old lady with biventricular non compaction and pulmonary arteriovenous fistula. She had deep cyanosis due to right to left shunt at two levels, through the stretched open patent foramen ovale due to severe right ventricular dysfunction and through the pulmonary arteriovenous malformation. The two feeders of the malformation were closed by device closure. The second feeder was closed by creating a venovenous loop via the patent foramen ovale, the pulmonary vein and through the pulmonary arteriovenous malformation into the pulmonary artery. To the best of our knowledge, this technique has never been described before in literature.Conclusion: This is a novel technique in the closure of pulmonary arteriovenous malformations, particularly in tortuous vessels which augment the difficulty in the placement of the delivery sheath and delivery of the occluder device.

scholarly journals Pulmonary arteriovenous malformation unmasked in pregnancy: A case report

2013 ◽  
Vol 6 (4) ◽  
pp. 179-181 ◽  
Author(s):  
Sheba Reshmi Anin ◽  
Wunmi Ogunnoiki ◽  
Tarun Sabharwal ◽  
Karen Harrison-Phipps
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteriovenous Malformation ◽  
Pulmonary Vasculature ◽  
Pulmonary Arteriovenous Malformations ◽  
Neurological Sequelae ◽  
Life Threatening ◽  
Arteries And Veins ◽  
In Pregnancy

Pulmonary arteriovenous malformations are anomalous communications between arteries and veins of the pulmonary vasculature. Its incidence is rare. Pulmonary arteriovenous malformations can be asymptomatic or cause profound cardiovascular compromise and adverse neurological sequelae, as a result of right to left shunting of deoxygenated blood. Pregnancy and its physiological demands can unmask and exacerbate pulmonary arteriovenous malformations with attendant risks of life threatening complications and rarely, death. This case report describes a first presentation of pulmonary arteriovenous malformation in pregnancy and the tendency for misdiagnosis with pulmonary embolism. A multidisciplinary approach to management is pertinent considering the challenges involved in deciding the appropriate therapeutic management in pregnancy which has to be weighed against potential maternal and fetal risks.

scholarly journals Successful treatment of bilateral multiple pulmonary arteriovenous malformations in a patient with brain abscess and severe hypoxemia using a combination of transcatheter embolotherapy and surgical resection: a case report

2020 ◽  
Author(s):  
Takahiro Ochi ◽  
Masako Chiyo ◽  
Takamasa Ito ◽  
Hideharu Furumoto ◽  
Toshihiko Sugiura ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Abscess ◽  
Surgical Resection ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteriovenous Malformation ◽  
Positive Pressure ◽  
Pulmonary Arteriovenous Malformations ◽  
Severe Hypoxemia ◽  
History Of ◽  
The Brain

Abstract Background: A pulmonary arteriovenous malformation is an abnormal dilated blood vessel that makes direct communication between a pulmonary artery and pulmonary vein and can be associated with hypoxemia or neurological complications, including brain abscess and cerebral infarction. Treatment of pulmonary arteriovenous malformation includes surgical resection and transcatheter embolotherapy, however the adaptation of therapies should be considered when a patient is in bad condition.Case presentation: A 51-year-old man was admitted after developing fever, consciousness disorder, and hypoxemia. Magnetic resonance imaging of the brain showed a brain abscess. Bilateral pulmonary arteriovenous malformations were found by contrast computed tomography. Because of a family history of PAVM, a history of epistaxis, and the existence of oral mucosa telangiectasia, he was diagnosed with hereditary hemorrhagic telangiectasia and brain abscess caused by right-to-left shunt. The brain abscess improved with antibiotic treatment; however, the administration of oxygen did not ameliorate his hypoxemia. His hypoxemia was exacerbated by positive pressure ventilation. Considering his systemic and respiratory condition, we considered surgery to involve a high degree of risk. After controlling his brain abscess and pneumonia, transcatheter embolotherapy was performed. This improved his systemic condition, enabling surgical treatment.Conclusions: This middle-aged patient suffering from brain abscess and severe hypoxemia with multiple pulmonary arteriovenous malformations was successfully treated by a combination of transcatheter embolotherapy and surgery. The adaptation and combination of therapies, as well as the sequence of treatments, should be considered depending on the patient status and lesions.

scholarly journals Variable Presentations in Pulmonary Arteriovenous Malformation

2020 ◽  
Vol 8 (2) ◽  
pp. 1-8
Author(s):  
Nasir Ahmad Lone ◽  
Akshit Kumar ◽  
Waseem Ahmed Sheikh
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Clinical Symptoms ◽  
Case Series ◽  
Neurological Complications ◽  
Pulmonary Arteriovenous Malformations ◽  
Exertional Dyspnea ◽  
Paradoxical Emboli

Pulmonary arteriovenous malformations (PAVM) are a group of vascular anomalies of lung which present with variable clinical symptoms. Most patients with PAVM are asymptomatic but it can cause dyspnea on exertion, paradoxical emboli to brain causing various central nervous system complications like stroke and brain abscess, hemoptysis and rupture. The age at the presentation can range from 1st to 7th decade but the majority of patients present before the age of 30 years. PAVM is strongly associated with hereditary haemorrhagic telangiectasis which presents with epistaxis, mucocutaneous telangiectasias and AV malformations of various organs. In our case series, we have patients ranging from 3 yrs to 75 years with presentation ranging from asymptomatic to exertional dyspnea, hemoptysis and neurological complications.

scholarly journals Pulmonary Arteriovenous Malformation as a Cause of Exercise Intolerance in Children: A Case Report

2020 ◽  
Author(s):  
Pierluigi Morreale ◽  
Veronica Notarbartolo ◽  
Giancarlo Allegro ◽  
Francesca Finazzo ◽  
Mario Giuseppe Vallone ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arterial Oxygen Saturation ◽  
Oxygen Desaturation ◽  
Exercise Intolerance ◽  
Pulmonary Arteriovenous Malformation ◽  
Arterial Oxygen ◽  
Selective Embolization ◽  
Insidious Onset ◽  
Bubble Test ◽  
Angio Ct

Pulmonary arteriovenous malformation (PAVMs) in children are rare lesions characterized by abnormal low resistance vascular structures connecting a pulmonary artery to a pulmonary vein, resulting in an intrapulmonary right-to-left shunt. The insidious onset and variable signs and symptoms make diagnosis difficult, especially in children. PAVMs  can be single or multiple, congenital or acquired, and up to 47-80% of cases are associated with hereditary hemorrhagic telangiectasia (HHT).We present the  case of a 12-year-old female teenager referred to our center for epistaxis, headache, fatigue and weakness, with evidence of mild oxygen desaturation.  Bubble test showed a right-to-left shunt and pulmonary angio-CT confirmed the diagnosis. Percutaneous selective embolization was performed with full recovery of normal arterial oxygen saturation. When differentiating between mild oxygen desaturation and exercise intolerance in children and adolescents, physicians should be aware of the possibility of PAVMs as a cause. 

scholarly journals Pulmonary Arteriovenous Malformation in Combination With Stroke.

2021 ◽  
Author(s):  
Jung Guen Cha ◽  
Jihoon Hong
Keyword(s):  
Pulmonary Embolism ◽  
Arteriovenous Malformation ◽  
Treatment Plan ◽  
Brain Magnetic Resonance Imaging ◽  
Rare Condition ◽  
Endovascular Embolization ◽  
Pulmonary Arteriovenous Malformation ◽  
Feeding Artery ◽  
Complex Situation ◽  
Segmental Artery

Abstract BackgroundAs pulmonary arteriovenous malformation (PAVM) include a right-to-left shunt, it can be accompanied by fatal complications such as stroke and brain abscess due to paradoxical embolism. There are few PAVM patients accompanied by concurrent pulmonary embolism, so the treatment sequence has not been established. Case presentationA 62-year-old female patient was transferred to our hospital with a simple PAVM and concurrent bilateral pulmonary embolism (PE). The acute thromboembolus was extended to the proximal segmental artery where the feeding artery originated. Anticoagulation was started, but on the fifth day of admission, the patient complained of left side weakness and brain magnetic resonance imaging revealed an acute infarction in the right lateral thalamus. This situation could lead to a dilemma between the risk of thrombus migration during catheter manipulation in PAVM embolization and another embolic event due to the late occlusion of the shunt during anticoagulation. This complex situation was successfully managed with delayed endovascular embolization for PAVM after four months of anticoagulation. The cause of PE in this patient was eventually diagnosed as antiphospholipid syndrome (APS).ConclusionThe authors reported a rare case of APS-induced PE in the PAVM feeding artery course that led to stroke during hospitalization. We successfully treated this patient with delayed endovascular embolization for PAVM after anticoagulation for PE and stroke. It is thought to be valuable in deciding for a treatment plan for this rare condition.

scholarly journals Hemoptysis due to Pulmonary Arteriovenous Malformation after Coil Embolization during Long-Term Follow-Up

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Masashi Shimohira ◽  
Kenji Iwata ◽  
Kengo Ohta ◽  
Yusuke Sawada ◽  
Takeshi Hashimoto ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Coil Embolization ◽  
Arteriovenous Malformations ◽  
Bronchial Artery ◽  
Ground Glass Opacity ◽  
Pulmonary Arteriovenous Malformations ◽  
Long Term Follow Up ◽  
History Of

A 28-year-old man with a history of coil embolization of multiple pulmonary arteriovenous malformations presented with hemoptysis 11 years after initial embolization. A cavity lesion in the left upper lobe, which was accompanied by deformed coils and ground-glass opacity, was considered responsible for hemoptysis. Embolization of the bronchial artery was performed.

Endovascular Management of Massive Hemoptysis Secondary to Systemic Collaterals in Previously Treated Pulmonary Arteriovenous Malformation

2019 ◽  
Vol 53 (8) ◽  
pp. 674-678
Author(s):  
Ujjwal Gorsi ◽  
Akash Bansal ◽  
Tejeshwar Singh Jugpal ◽  
Sreedhara Bettadahally Chaluvashetty ◽  
Manavjit Singh Sandhu
Keyword(s):  
Case Report ◽  
Pulmonary Artery ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Treatment Guidelines ◽  
Massive Hemoptysis ◽  
Pulmonary Arteriovenous Malformations ◽  
Endovascular Management ◽  
Previously Treated ◽  
Thin Walled

Pulmonary arteriovenous malformations (PAVMs) are abnormal connections between pulmonary artery and vein through a thin-walled aneurysmal sac, leading to a right-to-left shunt. These are commonly associated with hereditary hemorrhagic telangiectasia, and treatment guidelines have been set on how to approach their management. Incorrect proximal placement of an embolization device can lead to delayed recruitment of systemic collaterals leading to presentation with hemoptysis. We are presenting a case of a 17-year-old male with treated PAVMs and with fresh hemoptysis. In this case report, we attempt to explain the management of such a complication and follow the principles of arteriovenous malformation embolization on the left side.

scholarly journals Expansion of pulmonary arteriovenous malformations after grand mal seizures and other circumstances of PAVM growth

2019 ◽  
Vol 12 (8) ◽  
pp. e229886
Author(s):  
Ami Schattner ◽  
Ina Dubin
Keyword(s):  
Pulmonary Hypertension ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Slow Growth ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Pulmonary Arteriovenous Malformations ◽  
Review Of The Literature ◽  
Grand Mal ◽  
Paradoxical Emboli ◽  
Accelerated Growth

A woman with asymptomatic pulmonary arteriovenous malformation (PAVM) discovered incidentally on admission developed recurrent generalised seizures. Immediately after, the PAVM demonstrated marked expansion, and was safely resected. Congenital PAVMs (associated with hereditary haemorrhagic telangiectasia or sporadic) are considered stable lesions that exhibit very slow growth if at all. A review of the literature reveals all circumstances of accelerated growth of PAVM (puberty, pregnancy, postpartum, pulmonary hypertension) and suggests a novel mechanism of seizure-associated expansion. This is important because the size and rapid growth of PAVMs correlate with the potential for rupture and other ominous complications such as right to left shunt and paradoxical emboli. The new seizures–PAVM progression association mandates recognition since the risk of seizures in patients with PAVM is substantial. Our observations strongly suggest the need to monitor PAVM in patients with or without haemorrhagic telangiectasis by repeated imaging after generalised seizures to evaluate potential expansion and risk.

Sign in / Sign up

Export Citation Format

Share Document