Huge arteriovenous malformation due to chronic infection

Area of Science:

• Cardiology
• Thoracic Surgery
• Infectious Diseases

Background:

• Acquired pulmonary arteriovenous malformations (AVMs) are uncommon vascular anomalies.
• Chronic infections are a rare but recognized cause of acquired pulmonary AVMs.
• Large AVMs with complex vascular supply pose significant management challenges.

Purpose of the Study:

• To report a rare case of a massive acquired pulmonary AVM secondary to chronic infection.
• To describe the unique multi-systemic vascular supply of the AVM, including the ascending aorta.
• To detail the successful management strategy involving combined interventional and surgical approaches.

Main Methods:

• A 32-year-old male patient with a history of chronic infection presented with symptoms attributed to a large pulmonary AVM.
• Diagnostic workup included advanced imaging to delineate the AVM's complex vascular anatomy and feeding vessels.
• Treatment involved a combined approach of intra-arterial embolization followed by surgical resection of the malformation.

Main Results:

• The pulmonary AVM was characterized by extensive vascular connections originating from multiple systemic arteries, including the ascending aorta.
• The combined embolization and surgical resection resulted in complete closure of the AVM.
• The patient experienced a favorable outcome with resolution of symptoms post-intervention.

Conclusions:

• This case underscores the rarity and potential complexity of acquired pulmonary AVMs associated with chronic infections.
• Combined intra-arterial embolization and surgical resection represent an effective treatment modality for large and complex pulmonary AVMs.
• Early diagnosis and multidisciplinary management are crucial for optimal patient outcomes in such rare conditions.