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Incidental diagnosis of four pulmonary arteriovenous fistulas during patent foramen ovale closure: a case report

Published online by Cambridge University Press:  27 July 2020

Alessandro Andreis*
Affiliation:
Division of Cardiology, Città della Salute e della Scienza di Torino Hospital, Department of Medical Sciences, University of Turin, 10126Turin, Italy
Gabriella Agnoletti
Affiliation:
Pediatric Cardiology Department, Città della Salute e della Scienza di Torino Hospital, 10126Turin, Italy
Paolo Scacciatella
Affiliation:
Division of Cardiology, Città della Salute e della Scienza di Torino Hospital, Department of Medical Sciences, University of Turin, 10126Turin, Italy
*
Author for correspondence: Alessandro Andreis, Division of Cardiology, Città della Salute e della Scienza di Torino Hospital, Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126Turin, Italy. Tel: +390116335538. E-mail: alessandro.andreis@unito.it

Abstract

Cryptogenic cerebral ischemia in young patients is commonly ascribed to paradoxical embolism. We report the clinical case of a young patient with cryptogenic stroke and a patent foramen ovale, undergoing percutaneous closure of atrial septal defect. Contrast transoesophageal echocardiography at the end of the procedure demonstrated massive late residual right-to-left shunt, due to the coexistence of pulmonary arteriovenous fistulas that were subsequently closed. Routinary adoption of contrast transoesophageal echocardiography at the end of patent foramen ovale closure interventions may be useful to detect early and late residual shunts. Late residual shunts may be due to pulmonary fistulas, a well-known risk factor for recurrent thromboembolic events.

Type
Brief Report
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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