Central Large Pulmonary Arteriovenous Malformation with Aneurysmal Dilatation

Abstract

A centrally located large pulmonary arteriovenous malformation (PAVM) with aneurysmal formation is uncommon and the optimal treatment remains unclear. Here we report a 63-year-old female with a large PAVM located in the pulmonary hilum presenting with dyspnea and a brain abscess. A muscle-sparing thoracotomy with lobectomy of the left upper lobe was successfully performed under the guidance of three-dimensional reconstruction imaging of the thoracic vasculature.

Key words

Thoracic surgery - computed tomography - vascular malformation

Reference

• 1 Khurshid I, Downie G H. Pulmonary arteriovenous malformation.  Postgrad Med J. 2002;  78 191-197
• 2 Anabtawi I N, Ellison R G, Ellison L T. Pulmonary arteriovenous aneurysms and fistulas: anatomical variations, embryology, and classification.  Ann Thorac Surg. 1965;  1 277-285
• 3 Gossage J R, Kanj G. Pulmonary arteriovenous malformations. A state of the art review.  Am J Respir Crit Care Med. 1998;  58 643-661
• 4 Churton T. Multiple aneurysms of pulmonary artery.  Br Med J. 1897;  1 1233
• 5 Bosher L H, Blake A, Byrd B R et al. Analysis of the pathologic anatomy of pulmonary arteriovenous aneurysms with partial reference to the applicability of local excision.  Surgery. 1959;  45 91-101
• 6 McAllister K A, Grogg D W, Johnson C J et al. Endoglin, a TGF-β binding protein of endothelial cells, is the gene for hereditary haemorrhagic telangiectasia type I.  Nat Genet. 1994;  8 345-351
• 7 White R I, Lunch-Nyhan A, Terry P et al. Pulmonary arteriovenous malformations: techniques and long-term outcome of embolotherapy.  Radiology. 1988;  169 663-669
• 8 Hepburn J, Dauphinee J A. Successful removal of hemangioma of lung followed by disappearance of polycythemia.  Am J Med Sci. 1942;  204 681-687
• 9 Uthaman B, Al-Qbandi M, Abushaban L et al. Transcatheter closure of large arteriovenous fistula including pulmonary artery to left atrial fistula with Amplatzer septal occluder.  Catheter Cardiovasc Interv. 2007;  70 422-428
• 10 Lee D W, White R I, Egglin K et al. Embolotherapy of large pulmonary arteriovenous malformations: long-term results.  Ann Thorac Surg. 1997;  64 630-640