Amplatzer Vascular Plug Occlusion in a Child with Late-diagnosed Multiple Pulmonary Arteriovenous Malformations

Abstract

Pulmonary arteriovenous malformations (PAVMs) are abnormal direct connections between the pulmonary artery and pulmonary vein, which may result in a right to left shunt. Patients may be asymptomatic, but symptoms may gradually occur with the enlargement of the fistula. A 5-year-old Syrian female patient was followed by the primary care physician during the last year with a diagnosis of polycythemia. The patient reported headache and abdominal pain for the last three months and was referred to the pediatric cardiology outpatient clinic when clubbing was detected. Normal sinus rhythm was observed in electrocardiography and echocardiographic examination findings were normal. Thoracic computed tomography/angiography was performed and PAVM was detected in the upper segment of the lower left lobe. Catheter angiography was performed with the diagnosis of PAVM. The fistulas were closed using three vascular plugs. Transcutaneous oxygen saturation increased to 96% after the procedure.