scholarly journals Surgical lobectomy of pulmonary arteriovenous malformations in a patient with presentations regarded as sequela of tuberculosis: a case report

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Peng Teng ◽  
Weidong Li ◽  
Yiming Ni
Keyword(s):  
Oxygen Saturation ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteries ◽  
Bone Marrow Aspiration ◽  
Pulmonary Angiography ◽  
Pulmonary Arteriovenous Malformations ◽  
Low Oxygen ◽  
Case Presentation ◽  
Digital Clubbing ◽  
Arteries And Veins

Abstract Background Pulmonary arteriovenous malformations are uncommon conditions of abnormal communications between pulmonary arteries and veins, which are most commonly congenital in nature. Although such condition is not extremely rare, it is a challenge to the differential diagnosis of pulmonary problems such as hypoxemia and pulmonary lesions. Case presentation We report a meaningful case of a 23-year-old male presented with elevated hemoglobin (23.0 g/dl) on admission. Physical examination revealed cyanosis, digital clubbing and low oxygen saturation on room air. The patient was initially diagnosed as polycythemia vera while the subsequent result of bone marrow aspiration was negative. During further assessment, pulmonary arteriovenous malformations were detected by CT pulmonary angiography. Lobectomy was successfully performed with significant increase in oxygen saturation from 86 to 98%. The hemoglobin decreased to almost normal level of 14.9 g/dl 3 months after surgery and the patient had been followed up for nearly 5 years. Conclusions Pulmonary arteriovenous malformations should be suspected in patients with central cyanosis, digital clubbing, polycythemia, pulmonary lesion and without cardiac malformations. Embolization or surgery is strongly recommended to reduce the risks caused by pulmonary arteriovenous malformations.

scholarly journals Surgical Lobectomy of Pulmonary Arteriovenous Malformations in a Patient with Presentations Regarded as Sequela of Tuberculosis: A Case Report

2020 ◽  
Author(s):  
Peng Teng ◽  
Weidong Li ◽  
Yiming Ni
Keyword(s):  
Oxygen Saturation ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteries ◽  
Bone Marrow Aspiration ◽  
Pulmonary Angiography ◽  
Pulmonary Arteriovenous Malformations ◽  
Low Oxygen ◽  
Case Presentation ◽  
Digital Clubbing ◽  
Arteries And Veins

Abstract Background: Pulmonary arteriovenous malformations are uncommon conditions of abnormal communications between pulmonary arteries and veins, which are most commonly congenital in nature. Although such condition is not extremely rare, it is a challenge to the differential diagnosis of pulmonary problems such as hypoxemia and pulmonary lesions.Case presentation: We report a meaningful case of a 23-year-old male presented with elevated hemoglobin (23.0 g/dl) on admission. Physical examination revealed cyanosis, digital clubbing and low oxygen saturation on room air. The patient was initially diagnosed as polycythemia vera while the subsequent result of bone marrow aspiration was negative. During further assessment, pulmonary arteriovenous malformations were detected by CT pulmonary angiography. Lobectomy was successfully performed with significant increase in oxygen saturation from 86% to 98%. The hemoglobin decreased to almost normal level of 14.9 g/dl three months after surgery and the patient had been followed up for nearly 5 years.Conclusions: Pulmonary arteriovenous malformations should be suspected in patients with central cyanosis, digital clubbing, polycythemia, pulmonary lesion and without cardiac malformations. Embolization or surgery is strongly recommended to reduce the risks caused by pulmonary arteriovenous malformations.

scholarly journals Successful Lobectomy of Pulmonary Arteriovenous Malformations in a Patient Misdiagnosed as Tuberculosis and Polycythemia Vera: A Case Report

2020 ◽  
Author(s):  
Peng Teng ◽  
Weidong Li ◽  
Yiming Ni
Keyword(s):  
Oxygen Saturation ◽  
Polycythemia Vera ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteries ◽  
Bone Marrow Aspiration ◽  
Computed Tomographic Angiography ◽  
Postoperative Recovery ◽  
Pulmonary Arteriovenous Malformations ◽  
Low Oxygen ◽  
Digital Clubbing

Abstract Background: Pulmonary arteriovenous malformations are uncommon conditions of abnormal communications between pulmonary arteries and veins, which are most commonly congenital in nature. Although such condition is not extremely rare, it is an challenge in the differential diagnosis of pulmonary problems such as hypoxemia and pulmonary lesions.Case presentation: We report a meaningful case of a 23-year-old male presented with elevated hemoglobin (23.0 g/dl) on admission. Physical examination revealed cyanosis, digital clubbing and low oxygen saturation on room air. The patient was initially diagnosed as polycythemia vera while the subsequent result of bone marrow aspiration was negative. During further assessment, pulmonary arteriovenous malformations were detected by computed tomographic angiography of pulmonary artery. Lobectomy was successfully performed with significant increase of oxygen saturation from 86% to 98%. The patient received an uneventful postoperative recovery and was followed up for nearly 5 years without recurrence.Conclusions: Pulmonary arteriovenous malformations should be suspected in the patients with central cyanosis, digital clubbing, polycythemia and pulmonary lesion and without cardiac malformations. Embolization or surgery is highly recommended to reduce the risks caused by pulmonary arteriovenous malformations.

scholarly journals Approach to Pulmonary Arteriovenous Malformations: A Comprehensive Update

2020 ◽  
Vol 9 (6) ◽  
pp. 1927 ◽  
Author(s):  
Shamaita Majumdar ◽  
Justin P. McWilliams
Keyword(s):  
Chest Pain ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Gold Standard ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteries ◽  
Clinical Manifestations ◽  
High Flow ◽  
Pulmonary Arteriovenous Malformations ◽  
Institutional Experience ◽  
Arteries And Veins

Pulmonary arteriovenous malformations (PAVMs) are abnormal direct vascular communications between pulmonary arteries and veins which create high-flow right-to-left shunts. They are most frequently congenital, usually in the setting of hereditary hemorrhagic telangiectasia (HHT). PAVMs may be asymptomatic or present with a wide variety of clinical manifestations such as dyspnea, hypoxemia, or chest pain. Even when asymptomatic, presence of PAVMs increases patients’ risk of serious, potentially preventable complications including stroke or brain abscess. Transcatheter embolotherapy is considered the gold standard for treatment of PAVMs. Though previous guidelines have been published regarding the management of PAVMs, several aspects of PAVM screening and management remain debated among the experts, suggesting the need for thorough reexamination of the current literature. The authors of this review present an updated approach to the diagnostic workup and management of PAVMs, with an emphasis on areas of controversy, based on the latest literature and our institutional experience.

scholarly journals A case of dyspnea: respiratory failure due to pulmonary arteriovenous malformation

2019 ◽  
Vol 13 (4) ◽  
pp. 244-246
Author(s):  
Lucio Brugioni ◽  
Chiara Catena ◽  
Eugenio Ferraro ◽  
Serena Scarabottini ◽  
Francesca Mori ◽  
...  
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Respiratory Failure ◽  
General Population ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteries ◽  
Pulmonary Nodules ◽  
Pulmonary Arteriovenous Malformations ◽  
Angio Ct ◽  
Arteries And Veins

Pulmonary arteriovenous malformations (PAVMs) are abnormal communications between pulmonary arteries and veins. The clinical features suggestive of PAVMs are stigmata of right-to-left shunting (dyspnea, hypoxemia, cyanosis, cerebral embolism, brain abscess), unexplained hemoptysis, or hemothorax.We present a case of young man presented to Emergency Department complaining dyspnea, polycythemia and persistent hypoxemia. Angio-CT scan of the chest detected multiple PAVMs.PAVMs are uncommon in the general population, but they are an important consideration in the differential diagnosis of common pulmonary problems, including hypoxemia, pulmonary nodules, and hemoptysis

Bubble contrast echocardiography in detecting pulmonary arteriovenous malformations after modified Fontan operations

2001 ◽  
Vol 11 (5) ◽  
pp. 505-511 ◽  
Author(s):  
Eva Strömvall Larsson ◽  
Laszlo Solymar ◽  
Bengt O. Eriksson ◽  
Anne de Wahl Granelli ◽  
Mats Mellander
Keyword(s):  
Arteriovenous Malformations ◽  
Contrast Echocardiography ◽  
Arterial Oxygen Saturation ◽  
Pulmonary Arteries ◽  
Positive Contrast ◽  
Pulmonary Angiography ◽  
Arterial Oxygen ◽  
Colloid Solution ◽  
Pulmonary Arteriovenous Malformations ◽  
The Right

The development of pulmonary arteriovenous malformations is a well-known complication after Fontan operations, and may result in significant morbidity due to increasing arterial desaturation. We compared the use of bubble contrast echocardiography and pulmonary angiography in detecting such malformations. We also examined which anatomical and haemodynamic variables were associated with their development. Our study includes 20 patients who had undergone modified Fontan procedures, 10 with atriopulmonary and 10 with total cavopulmonary connections, in Gothenburg between 1980 and 1991. All patients underwent cardiac catheterisation and pulmonary angiography. Bubble contrast echocardiography was performed at the same time, with injection of agitated polygelin colloid solution (Haemaccel, Hoechst) into the right and left pulmonary arteries, respectively. Transoesophageal echocardiography was used to detect the appearance of bubble contrast in the pulmonary venous atrium. The aim was also to evaluate the role of hepatic venous blood. Of the 20 patients, 9 (45%) had a positive contrast echocardiography study, compared with only 2 (10%) detected by pulmonary angiography. Patients with positive contrast echocardiography had a significantly lower arterial oxygen saturation than those with negative studies, both at rest (88% vs 95%, p < 0.01) and during exercise testing (78% vs 89%, p = 0.01). Bubble contrast echocardiography is much more sensitive in detecting pulmonary arteriovenous malformations than pulmonary angiography. By injecting echo contrast into the right and left pulmonary arteries, the method can be made highly selective. Pulmonary arteriovenous malformations develop much more frequently in patients with the Fontan circulation than previously reported.

Pulmonary Arteriovenous Malformations

2018 ◽  
pp. 315-324
Author(s):  
Jeffrey S. Pollak
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteries ◽  
Vascular Lesions ◽  
Common Symptom ◽  
Pulmonary Arteriovenous Malformations ◽  
Capillary Bed ◽  
Arteries And Veins

Pulmonary arteriovenous malformations (PAVMs) are dilated directly, connecting pulmonary arteries and veins with no capillary bed. They are generally congenital and frequently occur in patients with autosomal-dominant hereditary hemorrhagic telangiectasia (HHT), so they should be screened for PAVM. HHT causes variable-sized arteriovenous malformations (AVMs) from telangiectases to larger connections and affects mucocutaneous surfaces. Epistaxis is the most common symptom, and these vascular lesions can occur in other organs, including the lungs, central nervous system, liver, and gastrointestinal (GI) tract. PAVMs can result in hypoxemia with dyspnea, paradoxical embolization with ischemic stroke and abscess formation, and hemorrhage. Treatment consists of embolization of sufficiently sized lesions; antibiotic prophylaxis before procedures prone to produce bacteremia, such as dental processes that can cause abscesses; and avoidance of air or clots in intravenous (IV) lines. Lifelong follow-up is essential to assess for adequacy of embolization and enlargement of PAVMs that are too small to embolize.

Rat model of pulmonary arteriovenous malformations after right superior cavopulmonary anastomosis

2002 ◽  
Vol 283 (5) ◽  
pp. H2151-H2156 ◽  
Author(s):  
Sandra L. Starnes ◽  
Brian W. Duncan ◽  
Charles H. Fraga ◽  
Shailesh Y. Desai ◽  
Thomas K. Jones ◽  
...  
Keyword(s):  
Von Willebrand Factor ◽  
Rat Model ◽  
Microvessel Density ◽  
Arteriovenous Malformations ◽  
Pulmonary Angiography ◽  
Time Dependent ◽  
Pulmonary Arteriovenous Malformations ◽  
Cavopulmonary Anastomosis ◽  
Von Willebrand ◽  
Willebrand Factor

We developed a rat model of pulmonary arteriovenous malformations after cavopulmonary anastomosis. We sought to determine whether this model reproduces the angiographic and histologic features seen in the human condition. Eight Sprague-Dawley rats underwent a right superior cavopulmonary anastomosis with the use of microsurgical techniques. Between 2 and 13 mo, pulmonary angiography was performed, the animals were euthanized, and the lungs were removed. Microscopic sections of the lung were stained with an endothelial-specific antibody (von Willebrand factor). Microvessel density was determined by counting vessels staining positively for von Willebrand factor, and the shunted and nonshunted (control) lungs were compared for each animal. Pulmonary angiography revealed time-dependent development of arteriovenous malformations. Microvessel density demonstrated a time-dependent increase in the shunted lung compared with the control lung (simple linear regression of the ratio of the microvessel density of the shunted lung divided by the microvessel density of the control lung on time; R 2 = 0.79, P = 0.003). This animal model reproduces the same angiographic and microscopic features of pulmonary arteriovenous malformations that develop in humans after cavopulmonary anastomosis. This appears to be a valid model that may be used to further study etiologic mechanisms for this phenomenon.

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