Hereditary hemorrhagic telangiectasia causing high output cardiac failure: treatment with transcatheter embolization

Trotter, Jacob

doi:10.1016/s0002-9270(98)00367-0

Cited by 10 publications

(16 citation statements)

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“…Thus, complete or partial symptomatic response could be achieved in 13 of 15 patients (87%). Good clinical response to HAE has been reported by other authors as well [16,18,19,20,22,24,27].…”

Section: Discussionsupporting

confidence: 55%

“…A review of the relevant literature has yielded 7 cases that have been treated with hepatic artery ligation or banding [9][10][11][12][13][14], 25 patients who have undergone HAE [11,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and 16 patients who have been . 4 a Chest radiograph of a patient with HHT presenting with cardiac failure and intractable abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

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Hepatic artery embolization for treatment of patients with hereditary hemorrhagic telangiectasia and symptomatic hepatic vascular malformations

et al. 2004

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At present there is no established therapy for treating patients with hereditary hemorrhagic telangiectasia (HHT) and symptomatic hepatic involvement. We present the results of a prospective study with 15 consecutive patients who were treated with staged hepatic artery embolization (HAE). Branches of the hepatic artery were selectively catheterized and embolized in stages using polyvinyl alcohol particles (PVA) and platinum microcoils or steel macrocoils. Prophylactic antibiotics, analgesics and anti-emetics were administered after every embolization. Clinical symptomatology and cardiac output were assessed before and after therapy as well as at the end of follow-up (median 28 months; range 10-136 months). Five patients had abdominal pain and four patients had symptoms of portal hypertension. The cardiac output was raised in all patients, with cardiac failure being present in 11 patients. After treatment, pain resolved in all five patients, and portal hypertension improved in two of the four patients. The mean cardiac output decreased significantly ( P<0.001) from 12.57+/-3.27 l/min pre-treatment to 8.36+/-2.60 l/min at the end of follow-up. Symptoms arising from cardiac failure resolved or improved markedly in all but one patient. Cholangitis and/or cholecystitis occurred in three patients of whom two required a cholecystectomy. One patient with pre-existent hepatic cirrhosis died as a complication of the procedure. Staged HAE yields long-term relief of clinical symptoms in patients with HHT and hepatic involvement. Patients with pre-existing hepatic cirrhosis may be poor candidates for HAE.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Hepatic artery embolization for treatment of patients with hereditary hemorrhagic telangiectasia and symptomatic hepatic vascular malformations

et al. 2004

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“…17,18,20,21,24,25,27,[29][30][31]35 Even though this procedure has ameliorated the symptoms of heart failure or splanchnic steal, it may cause hepatic or biliary necrosis, or both, as we and others have found, 25,29,30,42 and should therefore be used only under special circumstances, provided that shunting from the portal vein to the hepatic veins is ruled out.…”

Section: Discussionmentioning

confidence: 82%

Liver Disease in Patients with Hereditary Hemorrhagic Telangiectasia

et al. 2000

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“…More commonly, the disease affects the hepatic artery and vein. First described in 1971, high-output cardiac failure is the most common manifestation of large hepatic artery to hepatic vein shunting [9]. Reported cases of right-heart catheterization in patients with symptomatic hepatic AVMs have calculated shunts of 24% to 58% of the cardiac output.…”

mentioning

confidence: 99%

Hereditary Hemorrhagic Telangiectasia Presenting as High Output Cardiac Failure during Pregnancy

Goussous

Haynes

Najarian

et al. 2009

Cardiology Research and Practice

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High-output cardiac failure secondary to hepatic involvement is a rare complication of hereditary hemorrhagic telangiectasia (HHT). Here we report a 43-year-old woman who presented at 29 weeks gestation of her second pregnancy with complications of right-sided heart failure and preterm labor. After delivery via cesarean section, the patient was found to have intrahepatic arteriovenous malformations through non-invasive imaging. Subsequently, a family history of vascular malformations and epistaxis was elucidated and a diagnosis of HHT was made. This case is presented, along with a review of the literature and discussion of hepatic involvement in HHT with particular focus on the pregnant patient.

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Hereditary hemorrhagic telangiectasia causing high output cardiac failure: treatment with transcatheter embolization

Cited by 10 publications

References 0 publications

Hepatic artery embolization for treatment of patients with hereditary hemorrhagic telangiectasia and symptomatic hepatic vascular malformations

Hepatic artery embolization for treatment of patients with hereditary hemorrhagic telangiectasia and symptomatic hepatic vascular malformations

Liver Disease in Patients with Hereditary Hemorrhagic Telangiectasia

Hereditary Hemorrhagic Telangiectasia Presenting as High Output Cardiac Failure during Pregnancy

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