Related Experiment Video
Updated: Jul 1, 2026
07:34
Microsurgical Venous Pouch Arterial-Bifurcation Aneurysms in the Rabbit Model: Technical Aspects
Published on: May 11, 2011
14.0K
Surgical resection of diffuse pulmonary arteriovenous malformations (PAVMs)
Aden R Falk1, Lindsay J Nitsche1, Colleen E Bontrager1
1Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pa.
JTCVS Open
|March 10, 2025
Summary
Surgical resection of pulmonary arteriovenous malformations (PAVMs) is a safe and effective treatment, especially for diffuse-type PAVMs. This approach significantly improves oxygen saturation and patient outcomes, offering a viable alternative to embolization.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Interventional Pulmonology
Background:
- Pulmonary arteriovenous malformations (PAVMs) are abnormal connections between pulmonary arteries and veins, potentially causing severe complications.
- While embolization is common, diffuse-type PAVMs present unique challenges, often requiring alternative or combined treatment strategies.
- Significant morbidity and mortality are associated with untreated PAVMs, highlighting the need for effective management.
Purpose of the Study:
- To evaluate the safety and effectiveness of elective surgical resection for managing pulmonary arteriovenous malformations (PAVMs) in pediatric and adult patients.
- To assess patient outcomes, including symptom improvement, complication rates, and long-term survival following surgical intervention for PAVMs.
- To compare surgical resection outcomes with existing data on embolization therapies for PAVMs.
Main Methods:
- Retrospective analysis of 18 patients who underwent surgical resection for PAVMs between August 2009 and July 2023.
- Data collection included demographics, diagnosis, surgical approach (thoracotomy or VATS), resection type (lobectomy, segmentectomy, pneumectomy), and pre/postoperative parameters.
- Patients with hereditary hemorrhagic telangiectasia (HHT) were included; outcomes were analyzed descriptively.
Main Results:
- Surgical resection was performed on 18 patients, 12 with HHT, for indications including hemoptysis, dyspnea, and post-embolization persistence.
- Diffuse-type PAVMs (14/18) and complex PAVMs (4/18) were commonly resected, with most procedures via thoracotomy.
- Significant improvements were observed in median oxygen saturation (90% to 97%), with a low complication rate, short hospital stay, and 100% survival at median follow-up of 16 months.
Conclusions:
- Elective surgical resection is a safe and highly effective treatment for diffuse-type pulmonary arteriovenous malformations (PAVMs).
- The procedure leads to excellent outcomes, including improved oxygen saturation and functional status, with no reported bleeding recurrence.
- Surgical resection offers a valuable therapeutic option for PAVMs, particularly when embolization is insufficient or not feasible.
