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Giliberti P, De Rose DU, Landolfo F, Columbo C, Pugnaloni F, Santisi A, Conforti A, Secinaro A, Francalanci P, Bozza P, Chukhlantseva N, Savignoni F, Caforio L, Toscano A, Novelli A, Dotta A, Capolupo I, Bagolan P. Hemodynamic Assessment of a Large Pulmonary Arteriovenous Malformation in a Neonate: Case Report and Review of Literature. Pediatr Cardiol 2022; 43:1383-1391. [PMID: 35260923 DOI: 10.1007/s00246-022-02862-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022]
Abstract
Herein we report the case of a neonate with a prenatally diagnosed large pulmonary arteriovenous malformation, managed with minimally invasive hemodynamic monitoring in our Neonatal Intensive Care Unit. The combination of Near-Infrared Spectroscopy and Pressure Recording Analytical Method could guide neonatal management of critical cases of vascular anomalies: immediate data are offered to clinicians, from which therapeutic decisions such as timing of surgical resection are made to achieve a positive outcome. We also systemically collected and summarized information on patients' characteristics of previous cases reported in literature to data, and we compared them to our case.
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Affiliation(s)
- Paola Giliberti
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Domenico Umberto De Rose
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Francesca Landolfo
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy.
| | - Claudia Columbo
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Flaminia Pugnaloni
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Alessandra Santisi
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Andrea Conforti
- Newborn Surgery Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Aurelio Secinaro
- Advanced Cardiovascular Imaging Unit, Department of Imaging, "Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Paola Francalanci
- Department of Pathology, "Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Patrizia Bozza
- Department of Anesthesia and Critical Care, "Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Natalia Chukhlantseva
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Ferdinando Savignoni
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Leonardo Caforio
- Fetal Medicine and Surgery Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Alessandra Toscano
- Perinatal Cardiology Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Antonio Novelli
- Medical Genetics Laboratory, "Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Andrea Dotta
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Irma Capolupo
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
| | - Pietro Bagolan
- Newborn Surgery Unit, Medical and Surgical Department of Fetus, Newborn and Infant-"Bambino Gesù" Children's Hospital IRCCS, 00165, Rome, Italy
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Lin Y, Hogan W, Stillwell K, Moore P, Peyvandi S, Amin E, Quezada E. Giant Neonatal Pulmonary Arteriovenous Malformation: An Imaging and Management Challenge. CASE 2020; 4:526-530. [PMID: 33376847 PMCID: PMC7756164 DOI: 10.1016/j.case.2020.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A PAVM was diagnosed in a critically ill cyanotic neonate. Echocardiography played a pivotal role in establishing the diagnosis. Urgent transcatheter device occlusion resulted in immediate hemodynamic stabilization.
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Affiliation(s)
- Yalin Lin
- Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Whitnee Hogan
- Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Kristina Stillwell
- Division of Neonatology, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Phillip Moore
- Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Shabnam Peyvandi
- Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Elena Amin
- Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Emilio Quezada
- Division of Pediatric Cardiology, Department of Pediatrics, University of California, San Francisco, San Francisco, California
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3
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Gefen AM, White AJ. Asymptomatic pulmonary arteriovenous malformations in children with hereditary hemorrhagic telangiectasia. Pediatr Pulmonol 2017; 52:1194-1197. [PMID: 28608633 DOI: 10.1002/ppul.23686] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/15/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Children with Hereditary Hemorrhagic Telangiectasia (HHT) may have pulmonary arteriovenous malformations (AVMs), which can lead to symptoms of shortness of breath, exercise intolerance, clubbing, cyanosis and hemoptysis. However, some patients with pulmonary AVMs may be asymptomatic, placing them at risk for complications such as stroke or brain abscess if they are not identified and treated. This study examines the incidence of signs and symptoms associated with pulmonary AVMs in children with HHT known to have pulmonary AVMs. METHOD Sixty-one children with HHT and documented pulmonary AVMs were questioned for any symptoms possibly associated with their pulmonary AVMs, prior to embolization. RESULTS The results show that the majority of these children were asymptomatic (56%), and their AVMs were discovered by routine screening. Those who did experience symptoms most often complained of shortness of breath and exercise intolerance, although there was a tendency to blame other conditions, such as asthma or deconditioning (being out of shape), for these symptoms. Migraine headaches were common in those with pulmonary AVMs, regardless of whether they were symptomatic or not (17 of 61 children, 28%), although they were more common in those who were symptomatic (10 of 27, 37%) versus those who were asymptomatic (7 of 34, 21%). CONCLUSION Children with HHT and pulmonary AVMs are often asymptomatic. Routine screening for the presence of AVMs should be performed regardless of symptomatology.
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Affiliation(s)
- Ashley M Gefen
- Washington University School of Medicine, St. Louis, Missouri.,Department of Pediatrics, New York University School of Medicine, New York, New York
| | - Andrew J White
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
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Pulmonary Arteriovenous Malformation Causing Systemic Hypoxemia in Early Infancy. Case Rep Pediatr 2017; 2017:2841720. [PMID: 28373920 PMCID: PMC5360967 DOI: 10.1155/2017/2841720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 02/20/2017] [Indexed: 11/17/2022] Open
Abstract
Pulmonary arteriovenous malformation (AVM) is not routinely appreciated during the standard echocardiogram to assess for structural abnormalities or pulmonary hypertension. The distal pulmonary AVM is suspected only if an injection of agitated saline is performed and late entry of particles is appreciated in the left heart structures. A large or complex pulmonary AVM can result in significant right-to-left shunting and consequential systemic hypoxemia in the presence or absence of pulmonary hypertension. For direct visualization of the pulmonary AVM, computerized tomography (CT) scan is the procedure of choice. Here, we present two young infants with systemic hypoxemia who underwent standard medical management including mechanical ventilation and one patient was placed on extracorporeal membrane oxygenation (ECMO) before the diagnosis of pulmonary AVM was established. Subsequently, both patients have done well into mid-term follow-up after being treated successfully using transcatheter occlusion techniques in the cardiac catheterization laboratory during early infancy. We aim to emphasize the importance of a high index of suspicion for pulmonary AVM in infants with refractory systemic hypoxemia of unclear etiology.
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Devanagondi R, Tapio JB, Grifka RG. Transcatheter occlusion of large pulmonary arteriovenous malformations using multiple devices in a neonate. Catheter Cardiovasc Interv 2015; 85:430-4. [DOI: 10.1002/ccd.25561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/10/2014] [Accepted: 05/25/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Rajiv Devanagondi
- Division of Pediatric Cardiology; C. S. Mott Children's Hospital, University of Michigan Medical School; Ann Arbor Michigan
| | - Jason B. Tapio
- Metro Heart & Vascular, Metro Health Hospital; Wyoming Michigan
| | - Ronald G. Grifka
- Division of Pediatric Cardiology; C. S. Mott Children's Hospital, University of Michigan Medical School; Ann Arbor Michigan
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Yakes W, Baumgartner I. Interventional treatment of arterio-venous malformations. GEFASSCHIRURGIE 2014. [DOI: 10.1007/s00772-013-1303-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Left pulmonary artery banding to repair ipsilateral diffuse pulmonary arteriovenous fistula. J Cardiothorac Surg 2012; 7:77. [PMID: 22925775 PMCID: PMC3502510 DOI: 10.1186/1749-8090-7-77] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 07/18/2012] [Indexed: 12/03/2022] Open
Abstract
Congenital pulmonary arteriovenous fistula (PAVF) is a rare disease which causes hypoxemia by shunting deoxygenated blood from the pulmonary artery into pulmonary venous return. Lung transplantation is the most effective therapy to treat severe, diffuse PAVF. However, the availability of lungs for transplantation is limited in most parts in the world. For patients with diffuse PAVF affecting only one side of the lungs, ipsilateral pulmonary artery banding (PAB) is an effective treatment, but not yet standard of care. We report successful treatment of a patient with diffuse left-sided PAVF with PAB. We believe that PAB is an effective therapy for severe unilateral PAVF and may serve as a bridge to lung transplantation.
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Gludovacz K, Vlasselaer J, Mesens T, Van Holsbeke C, Van Robays J, Gyselaers W. Early neonatal complications from pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: case report and review of the literature. J Matern Fetal Neonatal Med 2011; 25:1494-8. [DOI: 10.3109/14767058.2011.629250] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Ruf B, Eicken A, Schreiber C, Hess J. Clinical improvement after banding of a pulmonary branch artery in a symptomatic patient with Osler-Rendu-Weber syndrome. Pediatr Cardiol 2010; 31:136-7. [PMID: 19841965 DOI: 10.1007/s00246-009-9553-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 09/14/2009] [Indexed: 11/28/2022]
Abstract
We report a symptomatic newborn with Osler-Rendu-Weber syndrome, multiple and diffuse pulmonary arteriovenous malformations, and right-to-left shunting in the left lung. Right-to-left shunting was significantly decreased by selectively banding the left pulmonary branch artery and clipping one large feeding vessel so that total resection of the left lung could be avoided.
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Affiliation(s)
- Bettina Ruf
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
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Curie A, Lesca G, Cottin V, Edery P, Bellon G, Faughnan ME, Plauchu H. Long-term follow-up in 12 children with pulmonary arteriovenous malformations: confirmation of hereditary hemorrhagic telangiectasia in all cases. J Pediatr 2007; 151:299-306. [PMID: 17719943 DOI: 10.1016/j.jpeds.2007.03.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2006] [Revised: 12/21/2006] [Accepted: 03/14/2007] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess whether pulmonary arteriovenous malformation (PAVM) is associated with hereditary hemorrhagic telangiectasia (HHT). STUDY DESIGN This study was a review of 12 children (sex ratio = 1) including family history, mutation analysis, and long-term follow-up. RESULTS Five children were under age 3 years when PAVM was diagnosed. Presentations included pulmonary symptoms (n = 8), cerebral abscess (n = 2), and transient ischemic attack (TIA) (n = 1); 1 patient was asymptomatic. Nine of the 12 children (75%) had a family history of PAVM. The diagnosis of HHT was confirmed in all cases. A mutation in ENG was found in 9 of the 10 children available for testing. No mutation in ACVRL1 was found. During long-term follow-up (mean, 16 years), the following complications occurred: TIA (n = 2), hemoptysis (n = 2), and cerebral abscess (n = 2). Nine children experienced recurrence of PAVM. The children with no recurrence were those without a family history of PAVM. CONCLUSIONS The diagnosis of HHT should be considered in a child with an apparently isolated PAVM. Because serious complications may occur at any age, we recommend screening for PAVM and long-term follow-up in children from families with HHT, especially those with an ENG mutation.
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Affiliation(s)
- Aurore Curie
- Department of Clinical Genetics and National Reference Centre of Rendu-Osler Disease, Hôtel-Dieu Hospital, Civil Hospices of Lyon, University of Claude-Bernard Lyon 1, France.
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Borsellino A, Giorlandino C, Malena S, Trucchi A, Cilio R, Bagolan P. Early neurologic complications of pulmonary arteriovenous malformation in a newborn: an indication for surgical resection. J Pediatr Surg 2006; 41:453-5. [PMID: 16481270 DOI: 10.1016/j.jpedsurg.2005.11.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A case report of a neonate with pulmonary arteriovenous malformation is described. The anomaly was prenatally diagnosed, and family history was positive for Rendu-Osler-Weber syndrome. Because neurologic symptoms developed during the second week of life, surgical resection was deemed the best curative option to avoid further embolic events and reoccurrence of the lesion. Previous reports detailing coil embolization therapy for pulmonary arteriovenous malformation are discussed.
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Affiliation(s)
- Alessandro Borsellino
- Department of Medical and Surgical Neonatology, Bambino Gesù Children Hospital, 00165 Rome, Italy.
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McBrien AH, Sands AJ, Gladstone DJ. A large, single pulmonary arteriovenous fistula presenting hours after birth. IMAGES IN PAEDIATRIC CARDIOLOGY 2006; 8:1-6. [PMID: 22368663 PMCID: PMC3232564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- AH McBrien
- Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Falls Road, Belfast, Northern Ireland, BT12 6BE,Contact information: Andrew John Sands, Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Falls Rd, Belfast, Northern Ireland, BT12 6BE Telephone no: 0044 2890635351 Fax no: 0044 2890632878 andrew.sands@royal hospitals.n-i.nhs.uk
| | - AJ Sands
- Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Falls Road, Belfast, Northern Ireland, BT12 6BE
| | - DJ Gladstone
- Department of Cardiac Surgery, Royal Victoria Hospital, Grosvenor Rd, Belfast, Northern Ireland
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Farra H, Balzer DT. Transcatheter occlusion of a large pulmonary arteriovenous malformation using the Amplatzer vascular plug. Pediatr Cardiol 2005; 26:683-5. [PMID: 16096872 DOI: 10.1007/s00246-004-0857-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pulmonary arteriovenous malformation (AVM) is a rare entity with well-described signs, symptoms, and complications. Pulmonary AVMs can be congenital or acquired. They have been described in the setting of severe liver disease and after palliation with a Glenn shunt in which the hepatic venous blood flow has been excluded from the pulmonary blood flow. A variety of surgical and transcatheter interventions have been used to occlude AVMs. We report the use of the Amplatzer vascular plug to successfully occlude a pulmonary AVM in a 12-year-old patient.
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Affiliation(s)
- H Farra
- Division of Pediatric Cardiology, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO 63110, USA.
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Faughnan ME, Thabet A, Mei-Zahav M, Colombo M, Maclusky I, Hyland RH, Pugash RA, Chait P, Henderson KJ, White RI. Pulmonary arteriovenous malformations in children: outcomes of transcatheter embolotherapy. J Pediatr 2004; 145:826-31. [PMID: 15580209 DOI: 10.1016/j.jpeds.2004.08.046] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To describe outcomes of transcatheter embolotherapy (TCE) in children with pulmonary arteriovenous malformations (PAVMs). STUDY DESIGN Chart and imaging review of all children (age </=18 years) treated for PAVMs by TCE at three hereditary hemorrhagic telangiectasia centers. RESULTS All 42 treated patients were included, with a mean age of 12 years (range, 4 to 18). Cyanosis was present in 25 of 42 patients (60%). Hemoptysis had occurred in 3 of 42 patients (7%) and neurologic complications (stroke, cerebral abscess) occurred in 8 patients (19%) before assessment. PAVMs were focal in 30 of 42 (71%) and diffuse in 12 of 42 (29%) patients. TCE was performed for 172 PAVMs and 35 diffuse regions (regional TCE). Follow-up was obtained in 38 of 42 (90%) patients (mean, 7 years). After TCE in patients with focal PAVMs, oxygenation improved significantly, with no further complications from the PAVMs. Reperfusion was noted in 23 of 153 (15%) PAVMs. Eighteen of 23 (78 %) of these were retreated, with documented aneurysmal involution in 10 of 13 (77%) patients. TCE complications included pleuritic chest pain (24% of sessions) and deployment complications (device paradoxical embolization or device misplacement) (3% of sessions, 1% of PAVMs), with no long-term complications. CONCLUSIONS PAVMs cause life-threatening complications in children; treatment with TCE is safe, with complication rates comparable to adult rates.
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Affiliation(s)
- Marie E Faughnan
- Department of Medicine, Division of Respiratory Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
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Ravasse P, Maragnes P, Petit T, Laloum D. Total pneumonectomy as a salvage procedure for pulmonary arteriovenous malformation in a newborn: report of one case. J Pediatr Surg 2003; 38:254-5. [PMID: 12596117 DOI: 10.1053/jpsu.2003.50057] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pulmonary arteriovenous malformations are infrequent lesions diagnosed rarely in the neonatal period. A case of arteriovenous malformation involving an entire lung in a newborn is described. Because of an untractable cyanosis with heart failure, an emergency left total pneumonectomy had to be done at 18 hours of life. Cyanosis disappear immediately, and the newborn recovered normal cardiac function.
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Affiliation(s)
- Philippe Ravasse
- Department of Pediatric Surgery C.H.U. Côte de Nacre, Caen, France
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16
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Papagiannis J, Apostolopoulou S, Sarris GE, Rammos S. Diagnosis and management of pulmonary arteriovenous malformations. IMAGES IN PAEDIATRIC CARDIOLOGY 2002; 4:33-49. [PMID: 22368610 PMCID: PMC3232512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Pulmonary arteriovenous malformation is a rare anomaly that presents in several different ways. It can present as an isolated finding, or more often in the context of hereditary haemorrhagic telangiectasia. It can also complicate palliative surgery such as the Glenn operation for complex congenital heart disease with single ventricle physiology. Its management includes transcatheter embolization, which is the preferred mode of therapy, surgery (including resection of the affected lobe, segment, or the fistula itself), or rarely, medical therapy. Complications of the disease itself and of various modes of treatment are relatively common, and patients require close surveillance for possible recurrence, or development of new fistulas. In cases related to the Glenn operation, redirection of hepatic venous flow or heart transplantation may cure the problem.
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Affiliation(s)
- J Papagiannis
- Division of Pediatric Cardiology and Pediatric Cardiac Surgery, Onassis Cardiac Surgery Center,Contact information: Dr. John Papagiannis, Division of Pediatric Cardiology, Onassis Cardiac Surgery Center, 356 Sygrou Ave, 176 74 Kallithea-Athens, GREECE Telephone #: +3010-9493865 Fax #: +3010-9403853
| | - S Apostolopoulou
- Division of Pediatric Cardiology and Pediatric Cardiac Surgery, Onassis Cardiac Surgery Center
| | - GE Sarris
- Division of Pediatric Cardiology and Pediatric Cardiac Surgery, Onassis Cardiac Surgery Center
| | - S Rammos
- Division of Pediatric Cardiology and Pediatric Cardiac Surgery, Onassis Cardiac Surgery Center
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18
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Sharifi M, Messersmith R, Newman B, Chung Y, Lakier JB. Bronchial arteriovenous malformation in a child with hemoptysis. A case report. Angiology 1996; 47:203-9. [PMID: 8595017 DOI: 10.1177/000331979604700213] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Pulmonary arteriovenous (AV) malformations occur sporadically and in the pediatric population are most commonly associated with hereditary hemorrhagic telangiectasia. Hemoptysis is an infrequent presentation in this age group. Pulmonary angiography is considered to be the definitive diagnostic modality. The authors describe an otherwise healthy eleven-year- old girl who presented with massive hemoptysis secondary to a large bronchial AV malformation unrelated to any congenital anomalies. The pulmonary angiogram appeared normal and the diagnosis was established by digital subtraction aortography. Successful embolotherapy was performed by selective injection of polyvinyl alcohol particles into the culprit bronchial artery.
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Affiliation(s)
- M Sharifi
- Department of Medicine, Division of Cardiology, Lutheran General Hospital, Park Ridge, Illinois, USA
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