Direct Communication Between the Left Pulmonary Artery and the Left Atrium

Karnik, Ashok M.; Nilsson, Ulf; Vijayaraghavan, G; Hashmi, Jamil; H, Shuhaiber

doi:10.1378/chest.96.4.937

Cited by 16 publications

(7 citation statements)

References 5 publications

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“…In singular unilateral fistulas, most commonly the posterior opening is found in the posterior side of the right pulmonary artery and enters the right side of the left atrium [14–16]. We have found only one reported case describing a left pulmonary artery to left atrial connection [17] comparable to our case.…”

Section: Discussionsupporting

confidence: 71%

Rare case of pulmonary arteriovenous fistula simulating residual defect after transcatheter closure of patent foramen ovale for recurrent paradoxical embolism

Peters

Ewert

Schubert

et al. 2005

Cathet Cardio Intervent

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We report on a patient suffering from recurrent cerebrovascular events despite previous transcatheter closure of persistent foramen ovale (PFO) with a Helex occluder. There was evidence of persistent left-to-right atrial shunt shown by transesophageal contrast echocardiography and the patient was admitted to our institution for interventional closure of the supposed residual defect. However, the PFO was completely closed by the device and left pulmonary artery injections showed a pulmonary arteriovenous fistula in the left lower lobe. This rare malformation may well explain the recurrent paradoxical embolism. Transcatheter fistula closure with coils was performed successfully. This case underlines that the existence of an isolated pulmonary arteriovenous fistula as a right-to-left shunt in patients with cryptogenic stroke should not be overlooked, even if a PFO is present and pulmonary arteriovenous fistula is not suggested by the initial physical findings or chest X-ray.

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Section: Discussionsupporting

confidence: 71%

Rare case of pulmonary arteriovenous fistula simulating residual defect after transcatheter closure of patent foramen ovale for recurrent paradoxical embolism

Peters

Ewert

Schubert

et al. 2005

Cathet Cardio Intervent

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“…On the other hand, it must be borne in mind that although the fistula's origin is almost always in the right pulmonary branch, it is possible to find it originating from the left pulmonary branch; however, this possibility is very rare. 15,16 Analysing the cases published to date and the pertinent literature on this topic -confirmed by our two cases -there are two types or variants of clinical manifestations. The first type includes severe cardiac failure and cyanosis as in case 2.…”

Section: Comments About the Diagnostic Approachsupporting

confidence: 59%

“…[17][18][19][20][21] This group is found during the neonatal period and the severity and precocity of clinical findings depends on how big the shunt is and therefore on the size of the fistula. Hyperdynamic pulses, hepatomegaly, and tachycardia associated with the cyanosis are frequently found in this group and diagnosis is easier when a continuous murmur is present; 15 however, this finding is not always present. The second type includes cyanosis and chronic hypoxia as in case 1.…”

Section: Comments About the Diagnostic Approachmentioning

confidence: 93%

Right pulmonary artery to left atrial fistula: a description of two cases, emphasising a diagnostic approach

Díaz

Marquez²,

Gentile

2011

Cardiol Young

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Right pulmonary artery to left atrial fistula is a rare pathology characterised by a right to left shunt. Another important aspect of this pathology is the difficulty encountered in making a diagnosis, which is why the diagnosis is frequently delayed into adulthood. A description of two cases is used to emphasise the importance of the different modes of echocardiography as a diagnostic tool in diagnosis, as well as the two different clinical forms that it adopts: a group of patients suffering cardiac failure and cyanosis without apparent cause generally in neonates and a second group of mostly older patients with dyspnoea and cyanosis without apparent cause. Symptoms thus differ depending on the time of presentation and are related to the size of the fistula.

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“…The vast majority of these fistulas involve connection of the RPA to the left atrium or pulmonary veins. Only one reported case described an LPA to left atrial connection [6]. Most commonly, the opening of the fistula is located in the posterior side of the RPA and enters the cephalad right side of the left atrium.…”

Section: Case Reportmentioning

confidence: 99%

Transcatheter coil closure of a right pulmonary artery to left atrial fistula in an ill neonate

Slack¹,

Jedeikin²,

Jones³

2000

Cathet. Cardiovasc. Intervent.

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Direct Communication Between the Left Pulmonary Artery and the Left Atrium

Cited by 16 publications

References 5 publications

Rare case of pulmonary arteriovenous fistula simulating residual defect after transcatheter closure of patent foramen ovale for recurrent paradoxical embolism

Rare case of pulmonary arteriovenous fistula simulating residual defect after transcatheter closure of patent foramen ovale for recurrent paradoxical embolism

Right pulmonary artery to left atrial fistula: a description of two cases, emphasising a diagnostic approach

Transcatheter coil closure of a right pulmonary artery to left atrial fistula in an ill neonate

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