Massive pulmonary arteriovenous malformation presenting with tamponading haemothorax

Khan, Ayesha; Hunt, Ian; Hamdane, K; Tambiah, J.; Deshpande, Radhika; Reidy, J F

doi:10.1136/bcr.2006.071852

Cited by 4 publications

(2 citation statements)

References 2 publications

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“…A nivel pulmonar las manifestaciones clínicas de las FAVP en EROW son: hipoxemia como consecuencia del "shunt" de derecha a izquierda, lo que produce disnea, cianosis y policitemia; embolias paradójicas sistémicas especialmente a nivel cerebral (abscesos y accidentes isquémicos cerebrales) y sangrado (hemoptisis y hemotórax) por rotura 6 . La hemoptisis y el hemotórax espontáneo masivo pueden ser una forma infrecuente de presentación, lo que ha sido principalmente descrito en mujeres embarazadas en quienes el tamaño de la fístula experimenta un importante aumento [4][5][6][7][8][9][10] .…”

Section: Discussionunclassified

Tratamiento quirúrgico de fístula arteriovenosa pulmonar en telangectasia hemorrágica hereditaria (Enfermedad de Rendu Osler Weber)

et al. 2010

Rev Chil Cir

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Pulmonary arteriovenous fistula in hereditary hemorrhagic telangiectasia. Report of one caseHereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) is an autosomal dominant vascular disease that can be associated with pulmonary arteriovenous fistulas. We report a 16 years old female with an Osler-Weber-Rendu syndrome and a history of frequent episodes of epistaxis since the age of 10 years. A Chest CAT scan performed on that occasion showed an arteriovenous fistula. The patient presented with progressive dyspnea, low arterial oxygen saturation and clubbing of fingers. An echocardiogram and lung perfusion scintigram confirmed the presence a right to left shunt. The patient was subjected to a lobectomy with a good postoperative evolution. ResumenLas Fístulas Arteriovenosas Pulmonares (FAVP son malformaciones vasculares infrecuentes. La Telangectasia Hemorrágica Hereditaria o Enfermedad de Rendu-Osler-Weber (EROW) es una enfermedad hereditaria autosómica dominante que se asocia con frecuencia a dichas malformaciones vasculares pulmonares. Presentamos el caso de una mujer de 16 años con EROW y una FAVP única, sintomática y que comprometía extensamente el lóbulo medio, en quien realizamos tratamiento con cirugía resectiva pulmonar (lobectomía media) y que evolucionó satisfactoriamente con desaparición de la sintomatología.

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Section: Discussionunclassified

Tratamiento quirúrgico de fístula arteriovenosa pulmonar en telangectasia hemorrágica hereditaria (Enfermedad de Rendu Osler Weber)

et al. 2010

Rev Chil Cir

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“…Patient may then present with hemoptysis and hemothorax. [15,16] In addition, pregnancy carries a significantly higher risk of PAVM hemorrhage likely attributed to the increased cardiac output and blood volume during pregnancy. It is worth noting that PAVMs often increase in size and number during the pregnancy.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Endovascular Treatment of Pulmonary Arteriovenous Malformations: How We Do It

Alkukhun

Partovi

et al. 2018

The Arab Journal of Interventional Radiology

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Pulmonary arteriovenous malformation (PAVM) is a rare disease disproportionally affecting patients with hereditary hemorrhagic telangiectasia and may be associated with other pulmonary or infectious etiologies. Respiratory symptoms are the most common, including dyspnea, hypoxemia, and hemoptysis. Due to the impairment of normal pulmonary filtration function, patients with PAVM are at risk for embolic events, ranging from ischemic strokes to brain abscesses. More importantly, PAVM can enlarge over time or with physiological changes, which may lead to catastrophic hemorrhages and increased embolization risks. From imaging perspective, echocardiography with contrast bubbles and computed tomography can both be used to diagnose PAVMs with high sensitivity and specificity. Treatment modalities have evolved from invasive surgeries to transluminal catheter-based interventions. In recent decades, the evolution of interventional techniques and equipment has resulted in a high technical success rate for the treatment of PAVMs. Here, we present the interventional PAVM treatment protocol at our institution.

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Massive hemothorax induced by pulmonary arteriovenous malformation rupture: a case report and literature review

Li,

Duan,

et al. 2024

J Cardiothorac Surg

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Background Pulmonary arteriovenous malformation (PAVM), also known as pulmonary arteriovenous fistula, is a rare vascular developmental anomaly. Most cases of PAVM are associated with hereditary hemorrhagic telangiectasia (HHT). Hemothorax associated with PAVM is even rarer, and management concerning this complication still challenges. Case presentation A 55-year-old man with sudden onset of dyspnea and chest pain was admitted to our hospital. He had a medical history of epistaxis, intraperitoneal germ cell tumor and PAVM. Chest unenhanced CT revealed the left-sided pleural effusion together with partial passive atelectasis and gradual increase at the interval of six days. Diagnostic thoracocentesis further revealed hemorrhagic effusion. CT angiography (CTA) showed tortuously dilated lumen of the left lower pulmonary artery and PAVM with the formation of aneurysm. Due to his family's refusal of surgery, the patient underwent transcatheter embolization therapy. However, the left pleural effusion did not significantly reduce and there was a slow drop in hemoglobin value even after interventional treatment, indicating the possibility of ongoing active bleeding. Eventually, the patient received lobectomy of the left lower lobe with a satisfactory outcome. Conclusions Massive hemothorax resulting from PAVM rupture into the pleural space can lead to fatal outcomes. CTA can accurately diagnose this pathologic condition. Transcatheter embolization is frequently used in the treatment of PAVM, but it may be challenging to achieve the desirable effect in patients with hemothorax. Combined with our case and literature review, direct radical surgery can lead to a successful outcome when PAVM complicated with hemothorax and a large diameter of the draining vein.

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Massive pulmonary arteriovenous malformation presenting with tamponading haemothorax

Cited by 4 publications

References 2 publications

Tratamiento quirúrgico de fístula arteriovenosa pulmonar en telangectasia hemorrágica hereditaria (Enfermedad de Rendu Osler Weber)

Tratamiento quirúrgico de fístula arteriovenosa pulmonar en telangectasia hemorrágica hereditaria (Enfermedad de Rendu Osler Weber)

Endovascular Treatment of Pulmonary Arteriovenous Malformations: How We Do It

Massive hemothorax induced by pulmonary arteriovenous malformation rupture: a case report and literature review

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