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

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.

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 Exertional hypoxia in a healthy adult: a pulmonary arteriovenous malformation

2019 ◽  
Vol 12 (10) ◽  
pp. e231981
Author(s):  
Kyle Keinath ◽  
Megan Vaughn ◽  
Nathan Cole ◽  
Shari Gentry
Keyword(s):  
Differential Diagnosis ◽  
Chest Pain ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Healthy Adult ◽  
Pulmonary Arteriovenous Malformations ◽  
X Ray ◽  
Important Differential Diagnosis ◽  
Life Threatening ◽  
Chest X Ray

Pulmonary arteriovenous malformations (PAVMs) are a rare cause of pulmonary symptoms, including dyspnoea on exertion, hypoxemia and haemoptysis. PAVMs are an aetiology that is often overlooked by physicians when developing a differential diagnosis for pulmonary symptoms and unidentified lung masses. However, it is an important differential diagnosis to have as PAVMs can have serious sequelae including strokes, brain abscess and life-threatening bleeding. We present a case of an impressive PAVM presenting with chest pain, chronic cough, feelings of anxiety, mild resting hypoxemia and exertional hypoxemia. Of note, on previous chest X-ray, 8 years prior to presentation, an incidental mass was found during a shoulder repair presurgical workup but not further evaluated.

Multiple embolizations of pulmonary arteriovenous malformations during pregnancy

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Alexandria J. Hill ◽  
Caroline Martinello ◽  
Luis D. Pacheco ◽  
Rakesh B. Vadhera ◽  
Sunil K. Jain ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
High Risk ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Arteriovenous Malformations ◽  
Pregnant Patient ◽  
Pulmonary Arteriovenous Malformations ◽  
Life Threatening ◽  
In Pregnancy

AbstractPulmonary arteriovenous malformations in a pregnant patient are rare and can cause deleterious, life-threatening complications. We report a patient with multiple pulmonary arteriovenous malformations, with the subsequent diagnosis of hereditary hemorrhagic telangiectasia, requiring multiple embolizations during pregnancy. Pulmonary arteriovenous malformations can carry a high risk of morbidity in the pregnant woman; however, they can be safely treated in pregnancy.

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.

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.

Pulmonary Arteriovenous Malformation Treatment with Detachable Balloon: A Case Report

1996 ◽  
Vol 34 (5) ◽  
pp. 595 ◽  
Author(s):  
Young Min Han ◽  
Ho Young Song ◽  
Jeong Min Lee ◽  
Jin Young Chung ◽  
Sang Young Lee ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Pulmonary Arteriovenous Malformation ◽  
Detachable Balloon

scholarly journals Massive haemorrhagic complications of ruptured pulmonary arteriovenous malformations: outcomes from a 12 years’ retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xu Ma ◽  
Bing Jie ◽  
Dong Yu ◽  
Ling-Ling Li ◽  
Sen Jiang
Keyword(s):  
Arteriovenous Malformations ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Pulmonary Arteriovenous Malformations ◽  
Imaging Data ◽  
Peripheral Lung ◽  
Life Threatening ◽  
The Mean

Abstract Background The life-threatening haemorrhagic complications of pulmonary arteriovenous malformations (PAVMs) are extremely rare, and only described in isolated cases. This study was designed to comprehensively investigate management of ruptured PAVMs. Methods We retrospectively assessed clinical and imaging data of ruptured PAVMs to summarize incidence, clinical characteristics, and outcomes following embolisation between January 2008 and January 2021. Results Eighteen of 406 (4.4%) patients with PAVMs developed haemorrhagic complications. Twelve of 18 patients were clinically diagnosed with hereditary haemorrhagic telangiectasia (HHT). Haemorrhagic complications occurred with no clear trigger in all cases. Eight of 18 patients (44.4%) were initially misdiagnosed or had undergone early ineffective treatment. 28 lesions were detected, with 89.3% of them located in peripheral lung. Computed tomography angiography (CTA) showed indirect signs to indicate ruptured PAVMs in all cases. Lower haemoglobin concentrations were associated with the diameter of afferent arteries in the ruptured lesions. Successful embolotherapy was achieved in all cases. After embolotherapy, arterial oxygen saturation improved and bleeding was controlled (P < 0.05). The mean follow-up time was 3.2 ± 2.5 years (range, 7 months to 10 years). Conclusions Life threatening haemorrhagic complications of PAVMs are rare, they usually occur without a trigger and can be easily misdiagnosed. HHT and larger size of afferent arteries are major risk factors of these complications. CTA is a useful tool for diagnosis and therapeutic guidance for ruptured PAVMs. Embolotherapy is an effective therapy for this life-threatening complication.

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