Abstract
Arteriovenous fistulas between the systemic circulation and the pulmonary artery are extremely rare. Continuous precordial murmur is the usual clinical sign while unilateral rib notching may be the only radiologic manifestation of this condition. Selective angiographic investigation is necessary to localize the site of such an arteriovenous (AV) fistula before surgery is performed. In a review of the literature of 15 published cases, the majority were of congenital origin, with four of these systemic-pulmonary AV fistulas of traumatic origin, of which one occurred after insertion of an intercostal catheter. We describe one case of traumatic origin 9 years after percutaneous thoracic drainage for spontaneous pneumothorax, in which transcatheter embolic occlusion of the feeding arteries of an AV fistula was attempted. The advantages and the disadvantages of the nonsurgical and surgical therapeutic approaches are discussed.
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Kiphart RJ, MacKenzie JW, Templeton AW, Martin HA (1967) Systemic-pulmonary arteriovenous fistula of the chest wall and lung. A report of a case and review of the literature. J Thorac Cardiovasc Surg 54:113–120.
Stafford RW, Kronenberg MW, Dunbar JD, Wooley CF (1969) Continuous precordial murmurs due to internal mammary artery fistulas. Including internal mammary to pulmonary artery fistulas. Am J Cardiol 24:414–419
Brundage BH, Gomez AC, Cheitlin MD, Gmelich JT (1972) Systemic artery to pulmonary vessel fistulas. Report of two cases and a review of the literature. Chest 62:19–23
Hearne SF, Burbank MK (1980) Internal mammary artery-to-pulmonary artery fistulas. Case report and review of the literature. Circulation 62:1131–1135
Cox PA, Keshishian JM, Blades BB (1967) Traumatic arteriovenous fistula of the chest wall and lung. Secondary to insertion of an intercostal catheter. J Thorac Cardiovasc Surg 54:109–112
Wolarsky ER, Humphreys CH (1970) Systemic-pulmonary arteriovenous fistula. J Thorac Cardiovasc Surg 59:859–863
Saito T, Matsuda M, Yamaguchi T, Matsuzaki T, Nagakawa S, Akatsuka N (1975) A case of traumatic systemic-pulmonary arteriovenous fistula. Jpn Heart J 16:196–203
Dunn RP, Wexler L (1974) Systemic-to-pulmmonary fistula in intrapulmonary Hodgkin's disease. Chest 66:590–594
Pinet F, Delaye J, Amiel M, Rubet A, Clermont A, Veyret C, Devic J (1975) Congenital anomalies of the thoracic systemic circulation with cardiologic systems but without cardiopathy. (in French) Ann Radiol (Paris) 18:263–270
Mazer MJ, Baltaxe HA, Wolfe GL (1981) Therapeutic embolization of the renal artery with Gianturco coils: Limitations and technical pitfalls. Radiology 138:37–46
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Hirsch, M., Maroko, I., Gueron, M. et al. Systemic-pulmonary arteriovenous fistula of traumatic origin: A case report. Cardiovasc Intervent Radiol 6, 160–163 (1983). https://doi.org/10.1007/BF02552769
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DOI: https://doi.org/10.1007/BF02552769