Pulmonary arteriovenous malformations

Diagnosis

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Pulmonary arteriovenous malformations (PAVMs) are rare, abnormal low resistance vascular structures that connect a pulmonary artery to a pulmonary vein, thereby bypassing the normal pulmonary capillary bed and resulting in an intrapulmonary right-to-left shunt. The spectrum of PAVMs extends from microscopic lesions causing profound hypoxemia and ground glass appearance on computed tomography (CT) but with normal catheter angiographic findings to classic pulmonary aneurysmal connections that abnormally connect pulmonary veins and arteries. These malformations most commonly are seen in hereditary hemorrhagic telangiectasia (HHT). They are rarely due to secondary conditions such as post congenital heart disease surgery or hepatopulmonary syndrome (HPS). The main complications of PAVM result from intrapulmonary shunt and include stroke, brain abscess, and hypoxemia. Local pulmonary complications include PAVM rupture leading to life-threatening hemoptysis or hemothorax. The preferred screening test for PAVM is transthoracic contrast echocardiography (TTCE). CT has become the gold standard imaging test to establish the presence of PAVM. Endovascular occlusion of the feeding artery is the treatment of choice. Collateralization and recanalization of PAVM following treatment may occur, and hence long term clinical and imaging follow-up is required to assess PAVM enlargement and PAVM reperfusion.

Original languageEnglish (US)
Pages (from-to)325-337
Number of pages13
JournalCardiovascular Diagnosis and Therapy
Volume8
Issue number3
DOIs
StatePublished - Jun 1 2018

Fingerprint

Arteriovenous Malformations
Lung
Pulmonary Veins
Pulmonary Artery
Echocardiography
Hepatopulmonary Syndrome
Tomography
Hereditary Hemorrhagic Telangiectasia
Hemothorax
Brain Abscess
Hemoptysis
Vascular Resistance
Thoracic Surgery
Reperfusion
Glass
Rupture
Heart Diseases
Catheters
Arteries
Stroke

Keywords

  • Computed tomography (CT)
  • Diagnosis
  • Echocardiography
  • Hereditary hemorrhagic telangiectasia (HHT)
  • Pulmonary arteriovenous malformations (PAVMs)
  • Pulmonary catheter angiogram

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Pulmonary arteriovenous malformations: Diagnosis",
abstract = "Pulmonary arteriovenous malformations (PAVMs) are rare, abnormal low resistance vascular structures that connect a pulmonary artery to a pulmonary vein, thereby bypassing the normal pulmonary capillary bed and resulting in an intrapulmonary right-to-left shunt. The spectrum of PAVMs extends from microscopic lesions causing profound hypoxemia and ground glass appearance on computed tomography (CT) but with normal catheter angiographic findings to classic pulmonary aneurysmal connections that abnormally connect pulmonary veins and arteries. These malformations most commonly are seen in hereditary hemorrhagic telangiectasia (HHT). They are rarely due to secondary conditions such as post congenital heart disease surgery or hepatopulmonary syndrome (HPS). The main complications of PAVM result from intrapulmonary shunt and include stroke, brain abscess, and hypoxemia. Local pulmonary complications include PAVM rupture leading to life-threatening hemoptysis or hemothorax. The preferred screening test for PAVM is transthoracic contrast echocardiography (TTCE). CT has become the gold standard imaging test to establish the presence of PAVM. Endovascular occlusion of the feeding artery is the treatment of choice. Collateralization and recanalization of PAVM following treatment may occur, and hence long term clinical and imaging follow-up is required to assess PAVM enlargement and PAVM reperfusion.",
keywords = "Computed tomography (CT), Diagnosis, Echocardiography, Hereditary hemorrhagic telangiectasia (HHT), Pulmonary arteriovenous malformations (PAVMs), Pulmonary catheter angiogram",
author = "Saboo, {Sachin S.} and Murthy Chamarthy and Sanjeev Bhalla and Harold Park and Patrick Sutphin and Fernando Kay and John Battaile and Kalva, {Sanjeeva P.}",
year = "2018",
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TY - JOUR

T1 - Pulmonary arteriovenous malformations

T2 - Diagnosis

AU - Saboo, Sachin S.

AU - Chamarthy, Murthy

AU - Bhalla, Sanjeev

AU - Park, Harold

AU - Sutphin, Patrick

AU - Kay, Fernando

AU - Battaile, John

AU - Kalva, Sanjeeva P.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Pulmonary arteriovenous malformations (PAVMs) are rare, abnormal low resistance vascular structures that connect a pulmonary artery to a pulmonary vein, thereby bypassing the normal pulmonary capillary bed and resulting in an intrapulmonary right-to-left shunt. The spectrum of PAVMs extends from microscopic lesions causing profound hypoxemia and ground glass appearance on computed tomography (CT) but with normal catheter angiographic findings to classic pulmonary aneurysmal connections that abnormally connect pulmonary veins and arteries. These malformations most commonly are seen in hereditary hemorrhagic telangiectasia (HHT). They are rarely due to secondary conditions such as post congenital heart disease surgery or hepatopulmonary syndrome (HPS). The main complications of PAVM result from intrapulmonary shunt and include stroke, brain abscess, and hypoxemia. Local pulmonary complications include PAVM rupture leading to life-threatening hemoptysis or hemothorax. The preferred screening test for PAVM is transthoracic contrast echocardiography (TTCE). CT has become the gold standard imaging test to establish the presence of PAVM. Endovascular occlusion of the feeding artery is the treatment of choice. Collateralization and recanalization of PAVM following treatment may occur, and hence long term clinical and imaging follow-up is required to assess PAVM enlargement and PAVM reperfusion.

AB - Pulmonary arteriovenous malformations (PAVMs) are rare, abnormal low resistance vascular structures that connect a pulmonary artery to a pulmonary vein, thereby bypassing the normal pulmonary capillary bed and resulting in an intrapulmonary right-to-left shunt. The spectrum of PAVMs extends from microscopic lesions causing profound hypoxemia and ground glass appearance on computed tomography (CT) but with normal catheter angiographic findings to classic pulmonary aneurysmal connections that abnormally connect pulmonary veins and arteries. These malformations most commonly are seen in hereditary hemorrhagic telangiectasia (HHT). They are rarely due to secondary conditions such as post congenital heart disease surgery or hepatopulmonary syndrome (HPS). The main complications of PAVM result from intrapulmonary shunt and include stroke, brain abscess, and hypoxemia. Local pulmonary complications include PAVM rupture leading to life-threatening hemoptysis or hemothorax. The preferred screening test for PAVM is transthoracic contrast echocardiography (TTCE). CT has become the gold standard imaging test to establish the presence of PAVM. Endovascular occlusion of the feeding artery is the treatment of choice. Collateralization and recanalization of PAVM following treatment may occur, and hence long term clinical and imaging follow-up is required to assess PAVM enlargement and PAVM reperfusion.

KW - Computed tomography (CT)

KW - Diagnosis

KW - Echocardiography

KW - Hereditary hemorrhagic telangiectasia (HHT)

KW - Pulmonary arteriovenous malformations (PAVMs)

KW - Pulmonary catheter angiogram

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U2 - 10.21037/cdt.2018.06.01

DO - 10.21037/cdt.2018.06.01

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JO - Cardiovascular Diagnosis and Therapy

JF - Cardiovascular Diagnosis and Therapy

SN - 2223-3652

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