Salvage pneumonectomy for pulmonary arteriovenous malformation in a 12-year-old boy with brain abscess and hemiparesis: A fatal outcome

Large pulmonary arteriovenous malformations (PAVMs) constitute an uncommon cause of central cyanosis with septic embolism and brain abscess. This large right to left shunt can lead to chronic severe hypoxemia and significant morbidity and mortality if untreated. Conservative parenchyma-sparing lung...

Full description

Saved in:
Bibliographic Details
Published in:Lung India 2016-03, Vol.33 (2), p.202-204
Main Authors: Majumdar, Gauranga, Agarwal, Surendra, Pande, Shantanu, Chandra, Bipin
Format: Article
Language:English
Subjects:
Blood
Blood transfusions
Brain abscess
Care and treatment
Case Report
Catheters
Conflicts of interest
contrast echocardiography
cyanosis
Diagnosis
Embolisms
embolotheraphy
Hemiplegia
Lung diseases
lung resection
Methods
Ostomy
Patient outcomes
Pediatric diseases
Physiological aspects
Pneumonectomy
Pulmonary arteries
pulmonary arteriovenous malformation
Salvage
Surgery
Tomography
Veins & arteries
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Large pulmonary arteriovenous malformations (PAVMs) constitute an uncommon cause of central cyanosis with septic embolism and brain abscess. This large right to left shunt can lead to chronic severe hypoxemia and significant morbidity and mortality if untreated. Conservative parenchyma-sparing lung resection was used widely as treatment of choice. However, with the advent of embolotheraphy, it is considered the preferred mode of treatment with less invasiveness. We here report a 12-year-old boy with large aneurysmal pulmonary arteriovenous fistula presented with brain abscess and hemiparesis. He underwent thoracotomy and pneumonectomy for large PAVMs, and it was complicated with bleeding and massive blood transfusion. The patient developed acute renal failure as a postoperative complication and succumbed to it. We suggest proper look out for systemic collateral and their management by embolitheraphy either alone or in combination should be tried first. We also suggest median sternotomy and intrapericardial approach for pneumonectomy in such difficult situation can be helpful.
ISSN:0970-2113
0974-598X
DOI:10.4103/0970-2113.177452