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Submitted: 22 August 2012 Modified: 24 January 2017
HERDIN Record #: PCHRD12082215451423

Multiple bilateral pulmonary arteriovenous malformations (PAVMs) rupturing to the left pleura- managed by surgical lobectomy after a failed transcatheter embolization and complicated by postoperative empyema.

1Aris Dexter R. Rana,
2Francisco M. Peralta Jr.,
3Menandro V. Siozon
Section of Cardiothoracic Surgery, Department of Surgery - St. Luke's Medical Center

Abstract

Pulmonary arteriovenous malformations (PAVM's) are rare pulmonary vascular anomalies. PAVM's consist of abnormal communications between pulmonary arteries and pulmonary veins, causing right-to-left shunting, and thus, frequently with hypoxemia and dyspnea on exertion, although may remain asymptomatic and frequently undiagnosed, unless complications occur. This report presents a PAVM rupturing to the left pleura, a very uncommon clinical problem, but it is an important differential diagnosis of common pulmonary problems such as hemothorax, hypoxemia, and pulmonary nodules. We report a case of a 25 year old female with symptoms of chronic cyanosis and sudden onset of dyspnea. On radiologic evaluations, she was found to have multiple bilateral pulmonary arteriovenous malformations (PAVMs) with multiple blood supply coming from the pulmonary artery. A large PAVM from the left lung that ruptured to the left pleura was documented. An open surgical left lower lobectomy was successfully performed after a failed transcatheter embolization. This was complicated by postoperative empyma a month after hospital discharge which was managed with antibiotics, thoracostomy, open thoracotomy and drainage of empyma and decortication. Patient remained asymptomatic six months after the surgery. Diagnostics and treatement options for multiple PAVMs and management of postoperative empyma are discussed in this paper.

1.
Publication Type:
Journal
Publication Sub Type:
Case report
Title:
The Philippine Journal of Thoracic and Cardiovascular Surgery
Frequency:
Annual
Publication Date:
December 2007
Volume:
14
Page(s):
24-32
Publisher:
Philippine Association of Thoracic and Cardiovascular Surgeons, Inc.

LocationCall NumberAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No. 8 Fulltext (Request Document)
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