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Systemic artery-pulmonary vein fistula without sequestration.

C Pernot1, P Simon, J C Hoeffel

  • 1Department of Cardiology, Children Hospital, Vandoeuvre, France.

Pediatric Radiology
|January 1, 1991
PubMed
Summary

This rare condition involves an abnormal connection between the aorta and pulmonary veins in a child, leading to heart failure. Surgical removal of the affected lung lobe successfully treated the arteriovenous fistula.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Pediatric Medicine

Background:

  • Congenital arteriovenous fistulas (AVFs) are rare vascular malformations.
  • Pulmonary AVFs typically involve pulmonary arteries and veins, but aortopulmonary fistulas are exceptionally uncommon.
  • Absence of a pulmonary artery branch is a rare associated anomaly.

Observation:

  • A child presented with a continuous vascular murmur, indicative of abnormal blood flow.
  • The patient developed signs of heart failure due to a left-to-left shunt.
  • Diagnostic imaging revealed a large arteriovenous fistula within the left lower lobe of the lung.

Findings:

  • The fistula connected an aberrant artery originating from the aorta directly to the pulmonary veins.
  • Histopathological examination confirmed the extensive nature of the arteriovenous fistula.

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  • No associated bronchial tree anomalies were identified.

    • Implications:

    • This case highlights a rare variant of congenital pulmonary arteriovenous fistula.
    • Surgical resection (left lobectomy) can be an effective treatment for large, symptomatic aortopulmonary fistulas.
    • Understanding these rare vascular anomalies is crucial for accurate diagnosis and timely intervention in pediatric patients.