The Experts below are selected from a list of 231 Experts worldwide ranked by ideXlab platform
Mauno Harkonen - One of the best experts on this subject based on the ideXlab platform.
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hereditary hemorrhagic telangiectasia osler weber rendu disease complicated by Pulmonary Arteriovenous Fistula and brain abscess
Acta Medica Scandinavica, 2009Co-Authors: Mauno HarkonenAbstract:. A man who developed two brain abscesses was later found to have hereditary hemorrhagic telangiectasia with a Pulmonary Arteriovenous Fistula. Brain abscess is a known complication of Pulmonary Arteriovenous Fistulas. About 15 % of patients with hereditary hemorrhagic telangiectasia develop such a Fistula during their lives. Surgical resection of Pulmonary Arteriovenous Fistulas is recommended because of the risk of severe neurological sequelae.
Udita Naithani - One of the best experts on this subject based on the ideXlab platform.
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Segmentectomy for bilateral Pulmonary Arteriovenous Fistula with significant right to left shunt—a case report
Indian Journal of Thoracic and Cardiovascular Surgery, 2015Co-Authors: Vinay Naithani, Udita NaithaniAbstract:Pulmonary Arteriovenous Fistulas (PAVFs) are rare vascular malformations of the lung and bilateral lung involvement adds further to it. We are presenting a case report of 33-year-old male patient who presented with cyanosis (SpO2 76 %) and breathlessness. Investigations revealed bilateral Pulmonary Arteriovenous Fistula involving both the lower lobes. PAVFs were large, isolated and had aneurismal changes (8 × 6 cm on the right side and 3 × 3 cm on the left side). Staged lung resection was planed and right anterior and medial basal segmentectomy was done. Patient got rid of cyanosis and saturation has improved to 96 %. He was advised second surgery on the left side after 1 month but patient turned up after 7 years with massive haemoptysis and pain chest. Investigation showed that there was Fistula on the left side which has increased in size to 5 × 4 cm. Left lateral basal segmentectomy was done. Patient did well and became asymptomatic. This report highlights that large and localized Pulmonary Arteriovenous Fistula should be treated surgically sparing as much as lung tissue to preserve Pulmonary function.
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segmentectomy for bilateral Pulmonary Arteriovenous Fistula with significant right to left shunt a case report
Indian Journal of Thoracic and Cardiovascular Surgery, 2015Co-Authors: Vinay Naithani, Udita NaithaniAbstract:Pulmonary Arteriovenous Fistulas (PAVFs) are rare vascular malformations of the lung and bilateral lung involvement adds further to it. We are presenting a case report of 33-year-old male patient who presented with cyanosis (SpO2 76 %) and breathlessness. Investigations revealed bilateral Pulmonary Arteriovenous Fistula involving both the lower lobes. PAVFs were large, isolated and had aneurismal changes (8 × 6 cm on the right side and 3 × 3 cm on the left side). Staged lung resection was planed and right anterior and medial basal segmentectomy was done. Patient got rid of cyanosis and saturation has improved to 96 %. He was advised second surgery on the left side after 1 month but patient turned up after 7 years with massive haemoptysis and pain chest. Investigation showed that there was Fistula on the left side which has increased in size to 5 × 4 cm. Left lateral basal segmentectomy was done. Patient did well and became asymptomatic. This report highlights that large and localized Pulmonary Arteriovenous Fistula should be treated surgically sparing as much as lung tissue to preserve Pulmonary function.
Peter Lange - One of the best experts on this subject based on the ideXlab platform.
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rare case of Pulmonary Arteriovenous Fistula simulating residual defect after transcatheter closure of patent foramen ovale for recurrent paradoxical embolism
Catheterization and Cardiovascular Interventions, 2005Co-Authors: Bjoern Peters, Peter Ewert, Stephan Schubert, Hashim Abdulkhaliq, Peter LangeAbstract:We report on a patient suffering from recurrent cerebrovascular events despite previous transcatheter closure of persistent foramen ovale (PFO) with a Helex occluder. There was evidence of persistent left-to-right atrial shunt shown by transesophageal contrast echocardiography and the patient was admitted to our institution for interventional closure of the supposed residual defect. However, the PFO was completely closed by the device and left Pulmonary artery injections showed a Pulmonary Arteriovenous Fistula in the left lower lobe. This rare malformation may well explain the recurrent paradoxical embolism. Transcatheter Fistula closure with coils was performed successfully. This case underlines that the existence of an isolated Pulmonary Arteriovenous Fistula as a right-to-left shunt in patients with cryptogenic stroke should not be overlooked, even if a PFO is present and Pulmonary Arteriovenous Fistula is not suggested by the initial physical findings or chest X-ray. Catheter Cardiovasc Interv 2005;64:348–351. © 2005 Wiley-Liss, Inc.
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huge Pulmonary Arteriovenous Fistula diagnosis and treatment and an unusual complication of embolization
Respiratory Care, 2002Co-Authors: Oliver Kretschmar, Peter Ewert, Hashim Abdulkhaliq, Mustafa Yigitbasi, H R Zurbrugg, R Hetzer, Peter LangeAbstract:We report the case of a 42-year-old woman with Rendu-Osler-Weber syndrome (hereditary hemorrhagic telangiectasia) and a huge Pulmonary Arteriovenous Fistula that involved the entire right middle lobe. She had a history of dyspnea and intermittent atrial flutter for 6 months. A chest radiograph showed a discrete shadowing of the middle part of the right lung. Arteriovenous Fistula was suspected based on the echocardiographic finding of immediate bubble detection in the left atrium on introducing echocardiographic contrast medium into the venous system. Atrial shunt was excluded. Angiography revealed a huge Pulmonary Arteriovenous Fistula in the entire middle lobe of the right lung. A trial of interventional embolization was performed, but the size of the Fistula made it impossible to achieve complete closure of all segmental Fistulas. Furthermore, the patient complained of unusual, severe chest pain after implantation of the first coil, so that the coil had to be removed. Therefore the patient underwent surgical resection of the entire right middle lobe and the upper part of the right lower lobe. Anatomy was clearly delineated and all connecting vessels were suture-closed, but both lungs showed diffuse microscopic superficial Pulmonary Arteriovenous Fistulas, which were too small to be detected by angiography and which were also partly closed. The postoperative course was uneventful: the patient recovered completely, she no longer had shortness of breath, and blood gas analysis showed normal P aO2 . It is not clear whether the patient's improved physical performance will last, because the development of diffuse microscopic Arteriovenous Fistulas bilaterally in the lungs is not predictable. Therefore close follow-up is necessary and in the case of recurrence (ie, enlargement of the existing small Fistulas), early interventional embolization should be performed.
Meihwan Wu - One of the best experts on this subject based on the ideXlab platform.
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isolated Pulmonary Arteriovenous Fistula in a patient with recurrent stroke
Acta Cardiologica Sinica, 2013Co-Authors: Chiaching Wang, Jaukau Wang, Chunan Chen, Meihwan WuAbstract:Paradoxical embolism is a risk factor for cryptogenic stroke in young adults, and can be primarily attributed to the presence of patent foramen ovale (PFO). Although contrast echocardiography may facilitate diagnosis, it would be difficult to distinguish a PFO from a Pulmonary Arteriovenous Fistula (PAVF), which could also result in paradoxical embolism. We report a 46-year-old woman with recurrent ischemic stroke, who was scheduled for PFO closure because of a right-to-left shunt detected by contrast echocardiography. The diagnosis turned out to be a PAVF confirmed by angiography. Thereafter, coil embolization of this PAVF was performed successfully.
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transcatheter closure of a huge Pulmonary Arteriovenous Fistula with embolization coils
Catheterization and Cardiovascular Diagnosis, 1997Co-Authors: Chiausuong Liau, Joukuo Wang, Meihwan WuAbstract:A 46-year-old female with bilateral Pulmonary Arteriovenous Fistulas was treated with Gianturco coil occlusion. The small right lung Fistula was closed with a 6 mm coil, whereas the huge left lung Fistula was occluded with three coils (one 10-mm and two 8-mm). Angiography 3 d later demonstrated recanalization of the left Fistula. Two 8 mm coils were inserted to achieve complete obstruction again. She developed Pulmonary infarction in the left lung 2 d later, which recovered without sequelae. We conclude that coil embolization for huge Pulmonary Arteriovenous Fistula is feasible but may result in Pulmonary infarction. Cathet. Cardiovasc. Diagn. 42:286–289, 1997.© 1997 Wiley-Liss, Inc.
Chiausuong Liau - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary Arteriovenous Fistula with Pulmonary hypertension to close or not to close
Acta Cardiologica Sinica, 2016Co-Authors: Chiausuong Liau, Jongkai HsiaoAbstract:A 37-year-old female presented to our facility suffering from exertional dyspnea for 2-3 months. Her chest x-ray showed a nodular shadow in the right lower lung, and chest CT revealed a Pulmonary Arteriovenous Fistula (PAVF). Subsequent echocardiographic examination detected no intra-cardiac shunt but did indicate Pulmonary hypertension as evidenced by a tricuspid regurgitation flow velocity of 4.17 M/sec. Contrast echocardiography with antecubital vein injection of agitated normal saline demonstrated visualization of the left heart chambers compatible with PAVF. At cardiac catheterization, Pulmonary arterial pressure was 59/26 mmHg, mean 34 mmHg. Because there was no intra-cardiac communication detected, primary Pulmonary hypertension was tentatively diagnosed. Pulmonary angiography demonstrated a PAVF arising from the lower right Pulmonary artery, forming a secular structure on its course in draining into the left atrium through a long Pulmonary vein. In this particular anomaly, a concurrence of PAVF with Pulmonary hypertension, we judged that the PAVF might serve as a safety valve for Pulmonary hypertension and should not be closed. We therefore left the PAVF untreated and thereafter provided medical management for this patient. The concomitant presence of PAVF and Pulmonary hypertension is a rare clinical condition. The ultimate treatment strategy for this uncommon condition should be carefully considered.
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transcatheter closure of a huge Pulmonary Arteriovenous Fistula with embolization coils
Catheterization and Cardiovascular Diagnosis, 1997Co-Authors: Chiausuong Liau, Joukuo Wang, Meihwan WuAbstract:A 46-year-old female with bilateral Pulmonary Arteriovenous Fistulas was treated with Gianturco coil occlusion. The small right lung Fistula was closed with a 6 mm coil, whereas the huge left lung Fistula was occluded with three coils (one 10-mm and two 8-mm). Angiography 3 d later demonstrated recanalization of the left Fistula. Two 8 mm coils were inserted to achieve complete obstruction again. She developed Pulmonary infarction in the left lung 2 d later, which recovered without sequelae. We conclude that coil embolization for huge Pulmonary Arteriovenous Fistula is feasible but may result in Pulmonary infarction. Cathet. Cardiovasc. Diagn. 42:286–289, 1997.© 1997 Wiley-Liss, Inc.
