High output heart failure caused by extensive arteriovenous malformation: problems and pregnancy

Dubrey, Simon W; Hillson, Rowan; Dahdal, Maher

doi:10.1136/bcr.07.2008.0546

Cited by 7 publications

(6 citation statements)

References 2 publications

(2 reference statements)

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“…Fifteen (31.3%) cases had high-output heart failure due to significant AV shunting. 13,21,24,26,29,30,33,34,38,41,48,49 There was no significant gender predominance (female-male ratio: 1:1), whereas 10 (66.7%) cases were 16 years of age or less. Moreover, a half of cases with upper limb involvement (3/6) were reported to have high-output heart failure, and more than one-fourth of cases (12/42) with affected lower limb developed high-output heart failure.…”

Section: Resultsmentioning

confidence: 89%

“…13,18,41,44,45,48 PWS and high-output heart failure Fifteen (31.3%) cases had high-output heart failure due to significant AV shunting. 13,21,24,26,29,30,33,34,38,41,48,49 There was no significant gender predominance (female-male ratio: 1:1), whereas 10 (66.7%) cases 23 46/M Limb amputation with chemotherapy Two months after died from pulmonary and cerebral metastases Ismail et al 24 16/M Hip disarticulation under low-flow cardiopulmonary bypass…”

Section: Patients' Characteristicsmentioning

confidence: 98%

“…Twelve (25.0%) cases were presented with chronic venous ulcerations of the affected limb 13,22,24,28,30,32,33,35,44,46,49,50 and four (8.3%) manifested distal arterial ischemia. 37,38,43,50 PWS and spinal AVM…”

Section: Pws and Venous Ulcerations/distal Arterial Ischemiamentioning

confidence: 99%

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Parkes Weber syndrome—Diagnostic and management paradigms: A systematic review

et al. 2016

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Objectives Parkes Weber syndrome is a congenital vascular malformation which consists of capillary malformation, venous malformation, lymphatic malformation, and arteriovenous malformation. Although Parkes Weber syndrome is a clinically distinctive entity with serious complications, it is still frequently misdiagnosed as Klippel-Trenaunay syndrome that consists of the triad capillary malformation, venous malformation, and lymphatic malformation. Methods We performed a systematic review investigating clinical, diagnostic, and treatment modalities of Parkes Weber syndrome (PubMed/MEDLINE, Embase, and Cochrane databases). Thirty-six publications (48 patients) fulfilled the eligibility criteria. Results The median age of patients was 23 years (IQR, 8-32), and 24 (50.0%) were males. Lower extremity was affected in 42 (87.5%) and upper extremity in 6 (12.5%) patients; 15 (31.3%) patients developed high-output heart failure; 12 (25.0%) patients had chronic venous ulcerations, whereas 4 (8.3%) manifested distal arterial ischemia. The spinal arteriovenous malformations were reported in six (12.5%) patients and coexistence of aneurysmatic disease in five (10.4%) patients. The most frequently utilized invasive treatments were embotherapy followed by amputation and surgical arteriovenous malformation resection, and occasionally stent-graft implantation. All modalities showed clinical improvement. However, long follow-up and outcome remained unclear. Conclusion A diagnosis of Parkes Weber syndrome should be made on the presence of capillary malformation, venous malformation, lymphatic malformation, and arteriovenous malformation (as main defect) in overgrowth extremity. Arteriovenous malformation presents the criterion for distinguishing Parkes Weber syndrome from Klippel-Trenaunay syndrome, which is substantial for treatment strategy. The primary management goal should be patient's quality of life improvement and complication reduction. Embolization alone/combined with surgical resection targeting occlusion or removal of arteriovenous malformation "nidus" reliably leads to clinical improvement.

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Section: Resultsmentioning

confidence: 89%

Section: Patients' Characteristicsmentioning

confidence: 98%

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Parkes Weber syndrome—Diagnostic and management paradigms: A systematic review

et al. 2016

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“…This distinction is important as it may lead to high-output cardiac failure. 6 Like PPV, the origin of most cases of KTWS is not fully understood and both familial and sporadic cases have been described. It has been hypothesized that vascular development is affected by a defect in the mesoderm.…”

Section: Discussionmentioning

confidence: 99%

Phacomatosis Pigmentovascularis: Simple Presentation of a Not So Simple Dermatological Condition

Kola

Mehrafza

Kane

2017

Clin Pediatr (Phila)

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“…Hormonal changes are thought to stimulate AVM progression, 3 and recurrent hemorrhage in women with extracranial AVM of various stage due to AVM progression may occur during or after pregnancies 1,5,6 . However, there is limited information on the clinical course of pregnancy in advanced‐stage AVMs 3,7 …”

Section: Introductionmentioning

confidence: 99%

Successful management of a pregnant woman of lower‐limb arteriovenous malformation with chronic cardiac failure

Kakigano

Matsuzaki

Mimura

et al. 2022

J of Obstet and Gynaecol

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The clinical features of extracranial arteriovenous malformations (AVM) vary from stages I (quiescence) with few symptoms to IV (decompensation) with overt symptoms of cardiac failure. Although the maternal outcomes of pregnant women with extracranial AVM is understudied due to its rarity, previous studies suggested the difficulty in the management of recurrent hemorrhage due to AVM progression during perinatal period; thus, pregnant case of extracranial AVM complicated with cardiac failure were considered challenging. We have reported a woman of stage IV extracranial AVM in the right lower limb with a history of below-the-knee amputation, in which two pregnancies and vaginal deliveries under epidural anesthesia were managed successfully. Cardiac failure did not exacerbate throughout the gestational or postpartum periods. Ulceration gradually worsened, with no massive hemorrhage. It is ideal to assess abnormal vascularity, especially in the lower abdomen, vagina, and epidural and subdural spaces, through magnetic resonance imaging to ensure safe delivery.

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High output heart failure caused by extensive arteriovenous malformation: problems and pregnancy

Cited by 7 publications

References 2 publications

Parkes Weber syndrome—Diagnostic and management paradigms: A systematic review

Parkes Weber syndrome—Diagnostic and management paradigms: A systematic review

Phacomatosis Pigmentovascularis: Simple Presentation of a Not So Simple Dermatological Condition

Successful management of a pregnant woman of lower‐limb arteriovenous malformation with chronic cardiac failure

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