Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-27T09:20:58.791Z Has data issue: false hasContentIssue false
  • English
  • Français

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 Open the ORCID record for Alessandro Andreis [Opens in a new window] ,
Gabriella Agnoletti  and
Paolo Scacciatella
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
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Pulmonary fistulaspatent foramen ovaleechocardiographycase report
Type
Brief Report
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1363 - 1365
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Meier, B, Lock, JE. Contemporary management of patent foramen ovale. Circulation 2003; 107: 5–9. doi: 10.1161/01.CIR.0000046073.34261.C1CrossRefGoogle ScholarPubMed
Alqoofi, F, Tyrrell, B, Feldman, T.Diagnosis and therapy for pulmonary arteriovenous fistula in patients with presumed patent foramen ovale. Catheter Cardiovasc Interv 2010; 75: 459–464. doi: 10.1002/ccd.22260Google ScholarPubMed
Saric, M, Armour, AC, Arnaout, MS, et al.guidelines for the use of echocardiography in the evaluation of a cardiac source of embolism. J Am Soc Echocardiogr 2016; 29: 1–42. doi: 10.1016/j.echo.2015.09.011CrossRefGoogle ScholarPubMed
Pristipino, C, Sievert, H, D’Ascenzo, F, et al.European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism. Eur Heart J 2019; 40: 3182–3195. doi: 10.1093/eurheartj/ehy649CrossRefGoogle ScholarPubMed
Meier, B.Catheter-based closure of the patent foramen ovale. Circulation. 2009; 120: 1837–1841. doi: 10.1161/CIRCULATIONAHA.109.903427CrossRefGoogle ScholarPubMed
Diaz, T, Cubeddu, RJ, Rengifo-Moreno, PA, et al.Management of residual shunts after initial percutaneous patent foramen ovale closure: a single center experience with immediate and long-term follow-up. Catheter Cardiovasc Interv 2010; 76: 145–150. doi: 10.1002/ccd.22475CrossRefGoogle ScholarPubMed
Thaler, DE, Ruthazer, R, Weimar, C, et al.Recurrent stroke predictors differ in medically treated patients with pathogenic vs other PFOs. Neurology 2014; 83: 221–226. doi: 10.1212/WNL.0000000000000589CrossRefGoogle ScholarPubMed
Seeger, J, Uber, A, Wöhrle, J. Long-term outcome after percutaneous closure of patent foramen ovale for cryptogenic ischemic events. J Invasive Cardiol 2019; 31: E242–E248.Google ScholarPubMed
Balbi, M, Canepa, M, Cheli, M, Bezante, GP, Brunelli, C.Sometimes they come back: recurrent noncardiac right-to-left shunt after percutaneous patent foramen ovale closure. J Cardiovasc Med (Hagerstown) 2017; 18: 443–446. doi: 10.2459/JCM.0b013e328351dac0CrossRefGoogle ScholarPubMed
Windecker, S, Wahl, A, Chatterjee, T, et al.percutaneous closure of patent foramen ovale in patients with paradoxical embolism long-term risk of recurrent thromboembolic events. Circulation 2000; 101: 893–898. doi: 10.1161/01.CIR.101.8.893CrossRefGoogle ScholarPubMed

Andreis et al. supplementary material

Andreis et al. supplementary material 1

Download Andreis et al. supplementary material(Video)
Video 8.8 MB

Andreis et al. supplementary material

Andreis et al. supplementary material 2

Download Andreis et al. supplementary material(Video)
Video 8.4 MB

Andreis et al. supplementary material

Andreis et al. supplementary material 3

Download Andreis et al. supplementary material(Video)
Video 13.1 MB