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.
Pulmonary arteriovenous aneurysm
Angiography of an arteriovenous lung aneurysm

Pulmonary arteriovenous aneurysm
Intraoperative situs of an arteiovenous lung aneurysm

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
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PAEDIATRIC SURGERY VIENNA
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