Asian Cardiovasc Thorac Ann 2007;15:76-77
© 2007 Asia Publishing EXchange Ltd
IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY |
Failed Embolization of Pulmonary Arterio-Venous Malformations
Atasha Asmat, MD,
Chee-Keong Ng, FACC1,
Chuen-Neng Lee, FRCS,
Poo-Sing Wong, FRCS
Department of Cardiac, Thoracic & Vascular Surgery, National University Hospital
1 Department of Cardiology, Tan Tock Seng Hospital, Singapore
For reprint information contact: Atasha Asmat, MD, Tel No: 65 6772 2060, Fax No : 65 6776 6475, Email : atashaa{at}nuh.com.sg, Department of Cardiac, Thoracic & Vascular Surgery, National University Hospital, 5 Lower Kent Ridge Road, Level 2, Main Building, Singapore 119074.
A 17 year-old male presented with multiple episodes of right-sided weakness with expressive dysphasia. Magnetic resonance imaging brain revealed numerous small arterio-venous malformations in the frontal, thalamic and temporal regions. Computed tomographic pulmonary angiography demonstrated a large pulmonary arterio-venous malformation in the left lower lobe of the lung (Figure 1a
).
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Figure 1a. CT pulmonary angiogram demonstrating pulmonary arterio-venous malformation in left lower lobe.
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The patient underwent multiple attempts at coil embolization (Figure 1b). Unfortunately they failed necessitating surgical treatment. A left thoracotomy and lower lobectomy was performed.
Operative findings were of numerous pulmonary arterio-venous malformations in the apical segment of the lower lobe. The left lower lobe was partially opened following surgery revealing the coils that were inserted during embolization (Figure 2). The patient made an uneventful recovery and was discharged home well on the 7th post-operative day.
