Pulmonary arteriovenous aneurysm
(AV - Aneurysma):

General information:

• Vascular malformation producing a shunt (usually high flow) between the pulmonary artery and the pulmonary vein.
  
• High shunt volumes may lead to a hyperdynamic cardiac failure.
  
• Location mainly in the right lung.

Symptoms:

• Cyanosis, clubbing of the fingers, polyglobulia.
  
• Right heart insufficiency.

Diagnostic workout:

• Angio - CT scan.
  
• Angiography of the pulmonary artery.
  
• Heart ultrasound (increased cardiac output; hypertrophic or dilated ventricles).
  
• ECG (hypertrophy).

Indication for operation:

• Clear indication for resection on an urgent basis.

Treatment/Operation:

• Thoracotomy, segmentectomy or lobectomy.
  

Postoperative management:

• Chest tubes may be removed if the lung is fully expanded and drainage volumes decrease below 20 to 50cc during a 24 hour period.
  

Prognosis:

• Good if cardiac insufficiency is reversible