Elective thoracic surgical resections for pulmonary arteriovenous malformations - a 16 year single-center experience
Author(s)
Al‐Sahaf, May
Anderson, Jon
Nandi, Jayanta
Alsafi, Ali
Shovlin, Claire L
Type
Journal Article
Abstract
Pulmonary arteriovenous malformations (PAVMs) cause cerebral abscess and ischemic stroke due to paradoxical emboli, risks that are increasingly recognized. We report the evolving placement of thoracic surgery in multi-disciplinary team management of PAVMs that were sporadic or associated with hereditary hemorrhagic telangiectasia. From 1983 to 2006, all patients receiving elective treatment had embolization. Between January 2006 and July 2022, 24 of 714 (3%) patients reviewed at our institution underwent elective surgical resection of one or more PAVMs. Initially, the bar for elective surgery had been set very high, and only patients with persistent symptoms of cerebral ischemia after maximal embolization and medical therapy were referred. As PAVM natural history, follow-up radiation exposures for residual PAVMs, and good surgical outcomes were appreciated, PAVM resection became part of the discussion for highly localized, very complex PAVMs which we consider are best treated surgically. Elective surgical intervention may be considered for other selected patients.
Date Issued
2025-01-01
Date Acceptance
2024-12-23
Citation
Pulmonary Circulation, 2025, 15 (1)
ISSN
2045-8940
Publisher
Wiley
Start Page
e70037
Journal / Book Title
Pulmonary Circulation
Volume
15
Issue
1
Copyright Statement
© 2025 The Author(s). Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39777301
PUL270037
Subjects
asymptomatic
hereditary hemorrhagic telangiectasia
hypoxemia
ischemic stroke
right‐to‐left shunt
1102 Cardiorespiratory Medicine and Haematology
Publication Status
Published
Coverage Spatial
United States
Article Number
e70037
Date Publish Online
2025-01-07