Korean J Thorac Cardiovasc Surg.  2017 Jun;50(3):215-219. 10.5090/kjtcs.2017.50.3.215.

Development of a Pulmonary Arteriovenous Fistula after a Modified Glenn Shunt in Tetralogy of Fallot and Its Resolution after Shunt Takedown in a 57-Year-Old Patient

• Kim SY
• Kim ER
• Bang JH
• Kim WH

• KMID: 2381907
• DOI: http://doi.org/10.5090/kjtcs.2017.50.3.215

Abstract

Pulmonary arteriovenous fistula (PAVF) is a complication of the Glenn shunt. A 57-year-old tetralogy of Fallot (TOF) patient, who had undergone a Glenn shunt and TOF total correction, complained of dyspnea and cyanosis. PAVFs were present in the right lung, and right lung perfusion was nearly absent. After coil embolization, takedown of the Glenn shunt, and reconstruction of the right pulmonary artery, the patient's symptoms were relieved. Extrapulmonary radioisotope uptake caused by the PAVFs shown in lung perfusion scans decreased, and right lung perfusion increased gradually. Although the development and resolution of PAVFs after a Glenn shunt have been reported in the pediatric population, this may be the first report on this change in old age.

Keyword

Fontan procedure; Hepatopulmonary syndrome; Pulmonary arteriovenous fistula; Tetralogy of Fallot; Angiogenesis inhibitor

MeSH Terms

Arteriovenous Fistula*
Cyanosis
Dyspnea
Embolization, Therapeutic
Fontan Procedure
Hepatopulmonary Syndrome
Humans
Lung
Middle Aged*
Perfusion
Pulmonary Artery
Tetralogy of Fallot*