All issues > Volume 48(2); 2005

Case Report

Korean J Pediatr. 2005;48(2):216-220. Published online February 15, 2005.

Two Case of Pulmonary Arteriovenous Fistula Treatment Depending on the Presence of Pulmonary Hypertension

Yun Jeong YJ Huh¹, Jeong Tae JT Kim¹, Jae Young JY Choi¹

¹Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea

Correspondence Jae Young JY Choi ,Email: cjy0122@yumc.yonsei.ac.kr

Abstract

Pulmonary arteriovenous fistulas(PAVFs) is a rare disorder that occurs in two to three children per 100,000 population. It is presented as absence of intervening capillary beds between the pulmonary artery and vein with resultant persistent right to left shunt. Other causes include trauma, liver cirrhosis, malignancy and schistosomiasis. It is mostly asymptomatic, but it may present with respiratory difficulty, cyanosis, clubbed fingers induced by right to left shunt or hemoptysis, polycythemia and epistaxis. Major complications, such as brain abscess, brain embolism, paradoxical embolism and subacute infective endocarditis can be devastating, so therapeutic intervention is recommended in all patients. However, removal of low-resistance fistulas can aggrevate pulmonary hypertension, so detection of increased pulmonary pressure is important. We report two patients : One a 42 year-old male with PAVFs treated with coil embolization, and a 42 year-old female who was treated with anticoagulants due to pulmonary hypertension.

Keywords :Arteriovenous fistula , Pulmonary , Hypertension , Embolization , Therapeutic