Pulmonary arteriovenous fistula with cerebral infarction successfully treated by video-assisted thoracic surgery

We experienced a case in which a pulmonary arteriovenous fistula was found due to the occurrence of cerebral infarction. The patient was a 65-year-old female who had seen a local doctor for lightheadedness occurring upon rising in the morning. She underwent a cerebral MRI and was diagnosed to have a cerebral infarction. Upon closer examination, a chest radiograph revealed an abnormal shadow and a three-dimensional computed tomography (3D-CT) chest angiography detected a pulmonary arteriovenous fistula 32x30 mm in size with the feeder blood vessel A10 and drainer blood vessel V10 in the left inferior lobe S10, which was considered to be the cause of the cerebral infarction. Video-assisted thoracic surgery (VATS) was conducted for a segmental resection of the basal segment of the left lung. The patient's postoperative progress was good and there was no reoccurrence of the cerebral infarction. The rate of occurrence of cerebral infarction along with pulmonary arteriovenous fistula is considered to be 11.4%; however, cerebral infarction may be an early indicator of pulmonary arteriovenous fistula, and therefore, due attention must be paid.