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Ishida Y, Yukawa T, Nagasaki Y, Minami D, Fujiwara H, Monobe Y, Fukazawa T, Yamatsuji T. A surgical case of pulmonary adenocarcinoma in the right upper lobe associated with a systemic artery-to-pulmonary artery fistula. Thorac Cancer 2023. [PMID: 37308179 PMCID: PMC10363778 DOI: 10.1111/1759-7714.14985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/14/2023] Open
Abstract
A 52-year-old female never-smoker with an abnormal shadow in the right lung detected on radiography was referred to our institution. Contrast-enhanced computed tomography revealed an irregular nodule in the upper lobe of the right lung, suggestive of a pulmonary vascular abnormality. Angiography revealed a direct communication between the right internal mammary artery (IMA) and the right upper lobe pulmonary artery branches, with dilated and tortuous vascular proliferation. As multiple branch arteries were seen flowing into the upper lobe from the IMA, transcatheter selective embolization of these vessels and right upper lobectomy by video-assisted thoracoscopic surgery were performed. Contrary to the clinical diagnosis, the pathological finding was a pulmonary adenocarcinoma of the right upper lobe. Additional lymph node dissection was performed later. We report an extremely rare and unprecedented case of pulmonary adenocarcinoma fed by the right IMA, with a literature review.
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Affiliation(s)
- Yuta Ishida
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Takuro Yukawa
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Yasunari Nagasaki
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Daisuke Minami
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Hiroyasu Fujiwara
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School, Okayama, Japan
| | - Yasumasa Monobe
- Department of Pathology 1, Kawasaki Medical School, Okayama, Japan
| | - Takuya Fukazawa
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | - Tomoki Yamatsuji
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
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Azimi-Ghomi O, Ramirez M, Brummund D, Gibber M, Mawad MR. Traumatic Pulmonary Arteriovenous Malformation Presenting as Spontaneous Hemothorax. Cureus 2021; 13:e16072. [PMID: 34345554 PMCID: PMC8324253 DOI: 10.7759/cureus.16072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 11/07/2022] Open
Abstract
Pulmonary arteriovenous malformations (PAVM), also known as pulmonary arteriovenous fistulas, are abnormal connections between the pulmonary arterial and venous systems. The majority occur secondary to the congenital syndrome hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu disease. Trauma is an extremely rare etiology of PAVM, comprising less than 1% of all reported cases. Trauma can be associated with both immediate and delayed development of PAVM, and present similarly to PAVM associated with HHT. We report a case of a traumatic PAVM that developed in a patient one year following blunt thoracic trauma with a rib fracture. The patient subsequently developed a rupture of the PAVM, resulting in spontaneous hemothorax. She required multi-unit blood transfusion and multiple thoracostomy tube placements. The patient subsequently underwent a failed attempt at angioembolization of the PAVM. She eventually required a thoracotomy for surgical excision of the PAVM. We discuss the traumatic etiologies, clinical presentation, diagnostic assessments, and therapeutic modalities for the management of PAVM.
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Affiliation(s)
| | - Marcela Ramirez
- Department of General Surgery, Kendall Regional Medical Center, Miami, USA
| | - Dieter Brummund
- Department of General Surgery, Kendall Regional Medical Center, Miami, USA
| | - Marc Gibber
- Department of Cardiothoracic Surgery, Aventura Hospital and Medical Center, Aventura, USA.,Department of Cardiothoracic Surgery, Kendall Regional Medical Center, Miami, USA
| | - Maurice R Mawad
- Department of Cardiothoracic Surgery, Kendall Regional Medical Center, Miami, USA.,Department of Cardiothoracic Surgery, Aventura Hospital and Medical Center, Aventura, USA
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3
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Mazza G, Garofalo M, Agnoletti G. Percutaneous treatment of anomalous systemic artery to pulmonary venous fistulas in children: Description of three cases and review of the literature. Ann Pediatr Cardiol 2021; 14:536-540. [PMID: 35527773 PMCID: PMC9075566 DOI: 10.4103/apc.apc_31_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/26/2021] [Accepted: 05/27/2021] [Indexed: 11/25/2022] Open
Abstract
In the normal lung, the only communications between the systemic and pulmonary arterial systems are the connections between the bronchial and pulmonary arteries that occur at the respiratory bronchioles, where pulmonary and bronchial capillaries freely anastomose. Rarely, anomalous connections can occur between normal or aberrant systemic arteries and pulmonary vessels. We performed a comprehensive literature review of all available manuscripts on PubMed and Google Scholar that included a case report or case series with diagnosis of systemic artery to pulmonary venous fistulas who underwent percutaneous treatment. Furthermore, we report three cases of children diagnosed and treated in our Pediatric Cardiology Center.
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Jacheć W, Tomasik A, Kurzyna M, Pietura R, Torbicki A, Głowacki J, Nowalany-Kozielska E, Wojciechowska C. The multiple systemic artery to pulmonary artery fistulas resulting in severe irreversible pulmonary arterial hypertension in patient with previous history of pneumothorax. BMC Pulm Med 2019; 19:80. [PMID: 30991994 PMCID: PMC6469086 DOI: 10.1186/s12890-019-0832-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 03/13/2019] [Indexed: 11/28/2022] Open
Abstract
Background Systemic artery to pulmonary artery fistulas (SA-PAFs), are extremely rare in people without congenital heart disease. In this group of patients pulmonary arterial hypertension was reported in the single case. Then, we describe a case of multiple SA-PAFs, which were the cause of severe nonreversible arterial pulmonary hypertension in a patient who had a right-sided pneumothorax 35 years earlier. Case presentation 52-year-old male Caucasian patient with echocardiographically confirmed pulmonary hypertension (PH) was admitted to cardiology department due to exertional dyspnea and signs of right ventricle failure. Routine screening for causes of secondary PH was negative. Right heart catheterization (RHC) confirmed a high degree arterial PH [mean pulmonary artery pressure (mPAP); 50,6 mmHg, pulmonary wedge pressure (PWP); 11,3 mmHg, pulmonary vascular resistance (PVR); 11,9 Wood’s units (WU)] irreversible in the test with inhaled nitric oxide. Oxygen saturation (SaO2) of blood samples obtained during the first RHC ranged from 69.3 to 73.2%. Idiopathic pulmonary arterial hypertension was diagnosed. Treatment with inhaled iloprost and sildenafil was initiated. Control RHC, performed 5 months later showed values of mPAP (59,7 mmHg) and PVR (13,4 WU) higher in comparison to the initial measurement, SaO2 of blood obtained during RHC from upper lobe artery of the right lung was elevated and amounted 89.7%. Then, pulmonary arteriography was performed. Lack of contrast in the right upper lobe artery with the evidence of retrograde blood flow visible as a negative contrast in the right pulmonary artery was found. Afterwards, right subclavian artery arteriography detected a huge vascular malformation communicating with right upper lobe artery. Following computed tomography angiogram (angio-CT) additionally revealed the enlargement of bronchial arteries originated fistulas to pulmonary artery of right upper lobe. In spite of intensive pharmacological treatment, including the therapy of pulmonary hypertension and percutaneous embolisation of the fistulas, the patient’s condition continued to deteriorate further. He died three months after embolisation due to severe heart failure complicated by pneumonia. Conclusion Non-congenital SA-PAFs are extremely rare, however, they should be excluded in patients with pulmonary arterial hypertension and history of inflammatory or infectious disease of the lung and pleura, pneumothorax, cancer or Takayashu’s disease and after chest trauma.
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Affiliation(s)
- Wojciech Jacheć
- 2nd Department of Cardiology, School of Medicine with Dentistry Division in Zabrze, Medical University of Silesia, 10 Curie-Sklodowska str, 41-808, Zabrze, Poland.
| | - Andrzej Tomasik
- 2nd Department of Cardiology, School of Medicine with Dentistry Division in Zabrze, Medical University of Silesia, 10 Curie-Sklodowska str, 41-808, Zabrze, Poland
| | - Marcin Kurzyna
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre Otwock, 14/18 Borowa str, 05-400, Otwock, Poland
| | - Radosław Pietura
- Department of Radiography Medical, University of Lublin, Staszica 11 str., 20-081, 20-954, Lublin, Poland
| | - Adam Torbicki
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre Otwock, 14/18 Borowa str, 05-400, Otwock, Poland
| | - Jan Głowacki
- Department of Radiology and Nuclear Medicine, School of Medicine with Dentistry Division in Zabrze, Medical University of Silesia, 13-15 3-go Maja str, 41-800, Zabrze, Poland
| | - Ewa Nowalany-Kozielska
- 2nd Department of Cardiology, School of Medicine with Dentistry Division in Zabrze, Medical University of Silesia, 10 Curie-Sklodowska str, 41-808, Zabrze, Poland
| | - Celina Wojciechowska
- 2nd Department of Cardiology, School of Medicine with Dentistry Division in Zabrze, Medical University of Silesia, 10 Curie-Sklodowska str, 41-808, Zabrze, Poland
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Goel D, Gupta P, Cooper S, Klimek J. A literature review of systemic to pulmonary collaterals in preterm infants to emphasise their existence and clinical importance. Acta Paediatr 2018; 107:1867-1878. [PMID: 29869341 DOI: 10.1111/apa.14434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 05/18/2018] [Accepted: 06/01/2018] [Indexed: 11/30/2022]
Abstract
AIM Cardiorespiratory physiology plays an important role in neonatal care with increasing utility of point-of-care ultrasound. This review is to bring to light the importance of systemic to pulmonary collaterals (SPCs) in the preterm population without congenital heart disease (CHD) and provide a useful diagnostic tool to the neonatologist performing a cardiac ultrasound. METHODS Medline, PubMed, EMBASE and the Internet were searched up to November 2017 for articles in English which included SPCs in preterm infants without CHD. This comprised title, abstract and full-text screening of relevant data. RESULTS A total of 10 studies which included case reports, retrospective observational studies and one small prospective cohort study were identified and analysed in detail. The studies had varying focus such as variable incidence, clinical presentation, association with chronic lung disease, pathophysiology and clinical importance of SPCs. SPCs were overall thought to be prevalent, underdiagnosed and of clinical significance in preterm infants. CONCLUSION Systemic to pulmonary collaterals are a potential left-to-right shunt in preterm infants and may contribute to worsening chronic lung disease (CLD) or heart failure. They should be carefully looked for when performing bedside cardiac ultrasound as the findings can mimic those seen in patent ductus arteriosus (PDA).
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Affiliation(s)
- Dimple Goel
- Westmead Hospital; Sydney Australia
- University of Sydney; Sydney Australia
- Children's Hospital at Westmead; Sydney Australia
| | - Pankaj Gupta
- Children's Hospital at Westmead; Sydney Australia
| | | | - Jan Klimek
- Westmead Hospital; Sydney Australia
- University of Sydney; Sydney Australia
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Ansari-Gilani K, Gilkeson RC, Hsiao EM, Rajiah P. Unusual Pulmonary Arterial Filling Defect caused by Systemic to Pulmonary Shunt in the Setting of Chronic Lung Disease Demonstrated by Dynamic 4D CTA. J Radiol Case Rep 2016; 9:17-23. [PMID: 27252791 DOI: 10.3941/jrcr.v9i11.2480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Even though pulmonary embolism is by far the most common cause of filling defect in the pulmonary arterial system, other less common etiologies should be considered especially in the setting of atypical clinical scenario or unusual imaging findings. Unusual pattern of filling defect in the pulmonary artery in the setting of chronic inflammatory/fibrotic parenchymal lung disease should raise the concern for systemic to pulmonary artery shunt. This diagnosis is typically made by conventional angiography. Dynamic 4D CT angiography however can be a safe, noninvasive and effective alternative tool for making such a diagnosis. It has the added value of multiplanar reconstruction capabilities and providing detailed anatomy which can be vital for interventional radiologists when planning their approach for possible intervention. We present 2 cases of such shunts, and illustrate the demonstration of these shunts by using dynamic 4D CT angiography.
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Affiliation(s)
- Kianoush Ansari-Gilani
- Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA
| | - Robert C Gilkeson
- Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA
| | - Edward M Hsiao
- Department of Radiology, Macquarie University Hospital, Macquarie University, Australia
| | - Prabhakar Rajiah
- Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA
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7
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Lee JK, Park JH, Kim J, Kim SJ, Lee AR, Lee CH, So YH. Embolization of multiple systemic artery to pulmonary artery fistula with recurrent hemoptysis. Tuberc Respir Dis (Seoul) 2013; 75:120-4. [PMID: 24101937 PMCID: PMC3790024 DOI: 10.4046/trd.2013.75.3.120] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/10/2013] [Accepted: 06/10/2013] [Indexed: 11/24/2022] Open
Abstract
Herein, we report a case of multiple systemic arteries to pulmonary artery fistulas without any underlying causes, presenting recurrent hemoptysis. Transcatheter embolization was successfully performed several times on multiple systemic feeding arteries. Multiple systemic arteries to pulmonary fistulas can be a source of uncontrolled bleeding, and embolization may be a reasonable therapeutic option to control the bleeding.
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Affiliation(s)
- Jung-Kyu Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
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8
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Iwazawa J, Nakamura K, Hamuro M, Nango M, Sakai Y, Nishida N. Systemic artery to pulmonary artery fistula associated with mitral regurgitation: successful treatment with endovascular embolization. Cardiovasc Intervent Radiol 2007; 31 Suppl 2:S99-103. [PMID: 18040737 DOI: 10.1007/s00270-007-9241-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Revised: 10/30/2007] [Accepted: 11/05/2007] [Indexed: 10/22/2022]
Abstract
We present the case of a 60-year-old woman with symptomatic mitral regurgitation caused by a left-to-right shunt via anastomoses consisting of microfistulae, most likely of inflammatory origin, between the right subclavian artery and the right pulmonary artery. The three arteries responsible for fistulous formation, including the internal mammary, thyrocervical, and lateral thoracic arteries, were successfully occluded by transcatheter embolization using superabsorbent polymer microsphere (SAP-MS) particles combined with metallic coils. No complications have been identified following treatment with SAP-MS particles. This approach significantly reduced the patient's mitral regurgitation and she has remained asymptomatic for more than 4 years.
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Affiliation(s)
- Jin Iwazawa
- Department of Radiology, Nissay Hospital, 6-3-8 Itachibori, Nishiku, Osaka, Japan.
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9
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Itano H, Lee S, Kulick DM, Iannettoni MD, Williams DM, Orringer MB. Nontraumatic chest wall systemic-to-pulmonary artery fistula. Ann Thorac Surg 2006; 79:e29-31. [PMID: 15854915 DOI: 10.1016/j.athoracsur.2005.01.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2005] [Indexed: 11/16/2022]
Abstract
A congenital chest wall systemic-to-left pulmonary artery fistula fed by the left internal mammary and left gastric arteries in a 31-year-old man is reported. Attempted sclerosis was complicated by rupture of the communicating vessel, hemothorax, and deep vein thrombosis of the legs. Fistula resection and pulmonary decortication were successfully performed.
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Affiliation(s)
- Hideki Itano
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
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10
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Peter AA, Ferreira AC, Zelnick K, Sangosanya A, Chirinos J, de Marchena E. Internal mammary artery to pulmonary vasculature fistula--case series. Int J Cardiol 2006; 108:135-8. [PMID: 16516712 DOI: 10.1016/j.ijcard.2005.03.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2005] [Revised: 03/07/2005] [Accepted: 03/12/2005] [Indexed: 11/24/2022]
Abstract
Internal mammary artery to pulmonary vasculature fistula is a rare condition that can be congenital or associated with coronary bypass surgery, trauma, inflammation, or neoplasia. We report six cases of symptomatic internal mammary artery to pulmonary vasculature fistula diagnosed after coronary bypass surgery using left internal mammary artery graft.
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11
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Fernández FJ, Montes PM, Alcíbar J, Rodrigo D, Barrenetxea JI, Gotxi R. Cierre percutáneo de una fístula compleja entre la arteria mamaria interna y la arteria lobar pulmonar. Rev Esp Cardiol 2004. [DOI: 10.1016/s0300-8932(04)77151-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Riehl G, Chaffanjon P, Frey G, Sessa C, Brichon PY. Postoperative systemic artery to pulmonary vessel fistula: analysis of three cases. Ann Thorac Surg 2003; 76:1873-7. [PMID: 14667603 DOI: 10.1016/s0003-4975(03)01056-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Systemic artery to pulmonary vessel fistulas (SAPVF) occur through pleural adhesions from miscellaneous origin. We report 3 cases of acquired SAPVF that developed late after thoracotomy. METHODS There was one pleurectomy for pneumothorax, one sleeve main bronchial resection, and one lower-middle bilobectomy. These SAPVF were discovered 4, 18, and 21 years after surgery. RESULTS One patient underwent two unsuccessful embolizations. One patient underwent an unsuccessful attempt at surgical treatment after a previous embolization. Both have persistent SAPVF with minimal clinical discomfort 5 and 13 years later. One patient remains without treatment. CONCLUSIONS In the literature 13 cases of SAPVF have been reported after lung resection, pleural drainage, axillary abcess drainage, closed chest trauma, parietal pleurectomy, and talc poudrage. Potential treatments of SAPVF include embolization, resection of pleural adhesion, and artery ligation. The effectiveness of these techniques is uncertain and the follow-up is too short to draw any clear conclusions. Embolization seems to be a useful tool in case of a single afferent artery. Surgical treatment seems to achieve more durable results than embolization but carries a higher risk of bleeding in the case of large SAPVF. Because SAPVF are well tolerated and complications are uncommon, clinical follow-up may be warranted in most cases.
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Affiliation(s)
- Gregory Riehl
- Service de Chirurgie Thoracique, Hôpital A Michallon, Grenoble, France
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13
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Acherman RJ, Siassi B, Pratti-Madrid G, Luna C, Lewis AB, Ebrahimi M, Castillo W, Kamat P, Ramanathan R. Systemic to pulmonary collaterals in very low birth weight infants: color doppler detection of systemic to pulmonary connections during neonatal and early infancy period. Pediatrics 2000; 105:528-32. [PMID: 10699104 DOI: 10.1542/peds.105.3.528] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Angiographic visualization of systemic to pulmonary collaterals (SPC) has been documented in premature infants needing prolonged ventilatory support. Noninvasive identification of such communications in premature infants was reported recently. The purpose of this study was to describe: 1) incidence, 2) clinical findings and implications, and 3) short-term follow-up of SPC diagnosed by echocardiography in very low birth weight (VLBW) infants admitted to the neonatal intensive care unit. METHODS From December 1, 1994 to August 31, 1996, 196 infants with birth weight <1500 g were admitted to the neonatal intensive care unit; 133 of them received serial echocardiographic evaluations at 1 to 2 days, at 2 weeks, and at 1, 2, and 3 months of life. Follow-up echocardiograms were scheduled at 6 months and 1 year of age for patients with SPC persisting at 3 months of age. RESULTS SPC were demonstrated in 88 patients (66%) at 1 to 90 days of life (mean 28 days). In most cases, the SPC originated at the distal aortic arch or the proximal descending aorta. Ten patients (11%) were treated for congestive heart failure. The symptoms improved and anticongestive therapy was discontinued in 9. One patient with persistent congestive heart failure underwent therapeutic cardiac catheterization and 1 prominent SPC was embolized. CONCLUSIONS The incidence of SPC in VLBW infants is much higher than previously reported. We postulate that SPC are bronchopulmonary communications that enlarge and/or proliferate in response to a given stimulus. These communications are associated with increased time on positive pressure ventilation and length of stay in the hospital. SPC may lead to pulmonary edema and should be searched for in VLBW infants with a more complicated course. Echocardiographic examination with color Doppler performed in premature infants to evaluate left to right shunts should include careful search for systemic to pulmonary collaterals.echocardiography, systemic to pulmonary collaterals, aortopulmonary collaterals, prematurity, pulmonary edema.
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Affiliation(s)
- R J Acherman
- Department of Pediatrics, University of Southern California, Women's and Children's Hospital Los Angeles, CA 90033, USA.
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14
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Misumi I, Ueno K, Kimura Y, Hokamura Y, Yamabe H, Yasunaga T, Oguni T, Asao C. Bilateral fistulas from the internal mammary arteries and the bronchial arteries to the pulmonary arteries--a case report. Angiology 1998; 49:771-5. [PMID: 9756430 DOI: 10.1177/000331979804901010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 78-year-old man was admitted to hospital with heart failure and chronic bronchitis. A computed tomographic scan of the chest incidentally demonstrated bilateral abnormal vessels near the left atrium. Selective angiography showed that both internal mammary arteries and bronchial arteries communicated with the pulmonary arteries bilaterally. The patient refused surgery and was discharged on medical therapy. This is the first reported case of bilateral fistulas between the internal mammary arteries and bronchial arteries and the pulmonary arteries.
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Affiliation(s)
- I Misumi
- Department of Cardiology, Kumamoto City Hospital, Kumamoto, Japan
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15
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Thapar MK, Riff E, Halees Z. Intrapulmonary agenesis of venous system and bronchopulmonary arterial anastomosis. Heart 1991; 66:182-4. [PMID: 1883672 PMCID: PMC1024616 DOI: 10.1136/hrt.66.2.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Agenesis of the intrapulmonary and extrapulmonary veins of the right lung was found by angiography and histological examination in a three year old boy. Blood supplied by the intersegmental arteries drained via the pulmonary arteries of the right lung into main and left pulmonary arteries. This caused a shunt between the aorta and pulmonary artery. Agenesis of the pulmonary venous system as a cause of left to right shunt has not been reported before.
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Affiliation(s)
- M K Thapar
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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16
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Hirsch M, Maroko I, Gueron M, Goleman L. Systemic-pulmonary arteriovenous fistula of traumatic origin: a case report. Cardiovasc Intervent Radiol 1983; 6:160-3. [PMID: 6627263 DOI: 10.1007/bf02552769] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Arteriovenous fistulas between the systemic circulation and the pulmonary artery are extremely rare. Continuous precordial murmur is the usual clinical sign while unilateral rib notching may be the only radiologic manifestation of this condition. Selective angiographic investigation is necessary to localize the site of such an arteriovenous (AV) fistula before surgery is performed. In a review of the literature of 15 published cases, the majority were of congenital origin, with four of these systemic-pulmonary AV fistulas of traumatic origin, of which one occurred after insertion of an intercostal catheter. We describe one case of traumatic origin 9 years after percutaneous thoracic drainage for spontaneous pneumothorax, in which transcatheter embolic occlusion of the feeding arteries of an AV fistula was attempted. The advantages and the disadvantages of the nonsurgical and surgical therapeutic approaches are discussed.
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17
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Pillai R, Mitchell A, Jackson JW. Arterial fistula between the left internal mammary artery and left pulmonary artery. Thorax 1982; 37:386-7. [PMID: 7112477 PMCID: PMC459323 DOI: 10.1136/thx.37.5.386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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18
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Hearne SF, Burbank MK. Internal mammary artery-to-pulmonary artery fistulas. Case report and review of the literature. Circulation 1980; 62:1131-5. [PMID: 7418166 DOI: 10.1161/01.cir.62.5.1131] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A case of internal mammary artery-to-pulmonary artery fistula is presented, and all previously reported cases are reviewed. This represents a rare cause of a continuous precordial murmur that may be confused clinically with a patent ductus arteriosus. Patients are usually asymptomatic, and routine diagnostic tests may be of little help in establishing a diagnosis. Selective internal mammary angiography is the procedure of choice for confirmation and localization. The question of advisability of surgery for these patients remains unanswered.
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19
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Loebl EC, Platt MR, Mills LJ, Estrera AS. Pulmonary resection for a traumatic pulmonary arteriovenous fistula. J Thorac Cardiovasc Surg 1979. [DOI: 10.1016/s0022-5223(19)38216-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Berquist TH, Sheedy PF, Stanson AW, Brown LR, Payne WS. Systemic artery-to-pulmonary vein fistula in osteogenic sarcoma of the chest wall. CARDIOVASCULAR RADIOLOGY 1978; 1:261-3. [PMID: 283883 DOI: 10.1007/bf02552053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
An arteriovenous fistula between the systemic and pulmonary circulations may be congenital, as in bronchopulmonary sequestration, or the communication may be acquired. Inflammatory disease, trauma, and, rarely, neoplasm have been implicated as possible causes of acquired communications. We describe a patient who had a systemic artery-to-pulmonary vein fistula that was secondary to a recurrent sarcoma of the chest wall. Review of the literature failed to reveal a previous report of a similar case.
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