Lung transplantation in a patient with arteriovenous malformations

Svetliza, Graciela; Canal, Alicia de la; Beveraggi, Enrique; Giacoia, A; Ruiz, C Reig; Caruso, Enrique S; Giménez, José Rodriguez; Vassallo, B C

doi:10.1016/s1053-2498(01)00365-5

Cited by 32 publications

(19 citation statements)

References 4 publications

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“…Visceral involvement includes pulmonary, gastrointestinal, and cerebral AVMs, which have been reported predominantly in adults. Visceral AVMs and these complications are sometimes life threatening, and lung 4) and liver transplantations 5) have recently been performed in patients with Osler's disease. Before cardiac surgery using ECC, careful preoperative screening of systemic AVMs is indispensable.…”

Section: Discussionmentioning

confidence: 99%

A Second Mitral Valve Replacement in a Patient With Hereditary Hemorrhagic Telangiectasia (Osler's Disease)

et al. 2004

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SUMMARYA 62-year-old female with Osler's disease was admitted to our hospital because of fever and cardiac failure. The patient had undergone a mitral valve replacement (MVR) using a Carpentier-Edwards prosthetic valve 14 years earlier. A bacterial examination of arterial blood identified Streptococcus mitis. No arteriovenous malformations were detected in visceral organs. The patient underwent MVR using the same prosthetic xenograft after conservative treatment and management of repetitive epistaxis and decayed teeth. Intra-and postoperative bleeding were typical of a mitral valve reoperation. This is the first reported experience, to the best of our knowledge, of a second MVR in a patient with Osler's disease. (Jpn Heart J 2004; 45: 885-888)

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Section: Discussionmentioning

confidence: 99%

A Second Mitral Valve Replacement in a Patient With Hereditary Hemorrhagic Telangiectasia (Osler's Disease)

et al. 2004

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“…A combined therapeutic approach with endovascular and video-assisted thoracoscopic procedure has been described for the treatment of hemothorax due to a ruptured PAVM [135]. Lung transplantation has been done in few HHT patients with severe and diffuse PAVMs [136,137,138]. …”

Section: Treatment Of Pavmsmentioning

confidence: 99%

Pulmonary Vascular Manifestations of Hereditary Hemorrhagic Telangiectasia (Rendu-Osler Disease)

et al. 2007

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Hereditary hemorrhagic telangiectasia (HHT) or Rendu-Osler-Weber disease is a genetic disorder with autosomal dominance and variable penetrance, characterized by epistaxis, telangiectasia and visceral manifestations of the disease. The estimated minimal prevalence is 1/10,000 inhabitants. The diagnosis is established on clinical criteria, and may be further confirmed by the identification of causative mutations in either the ENG or the ACVRL1 gene coding for endoglin and ALK1, respectively. Pulmonary vascular manifestations of HHT include pulmonary arteriovenous malforma- tions (PAVMs; especially in patients with ENG mutations) and less frequently pulmonary hypertension (especially in patients with ACVRL1 mutations). In 15–33% of patients with HHT, PAVMs consist of abnormal communications between pulmonary arteries and pulmonary veins, causing right-to-left shunting, and thus, frequently hypoxemia and dyspnea on exertion, although PAVMs may remain asymptomatic and frequently undiagnosed unless complications occur. PAVMs result in severe and frequent complications often at a young age, which may reveal the diagnosis, e.g. transient ischemic attack and cerebral stroke (10–19% of patients), systemic severe infections and abscesses (including cerebral abscess in 5–19% of patients), and rarely massive hemoptysis or hemothorax. Infections in HHT are related to the right-to-left shunting that bypasses the pulmonary capillaries and facilitates the passage of septic or aseptic emboli into the systemic and especially cerebral circulation, and potentially to minor defects in innate immunity. Treatment of PAVMs based on transcatheter coil vaso-occlusion of the feeding artery significantly decreases right-to-left shunting, hypoxemia and dyspnea on exertion, and reduces the risk of systemic complications. Long-term follow-up is warranted after transcatheter vaso-occlusion of PAVMs due to frequent recanalization of treated PAVMs and development or growth of untreated PAVMs. Patients with HHT should be informed of the risk of PAVM and potentially severe complications occurring in heretofore asymptomatic subjects. All adult patients with HHT should be proposed systematic screening for PAVM, by contrast echocardiography (preceded by anteroposterior chest radiograph) or computed tomography of the chest. Pulmonary hypertension is rare in HHT, and may be due either to systemic arteriovenous shunting in the liver increasing cardiac output or be clinically and histologically indistinguishable from idiopathic pulmonary arterial hypertension. Pulmonary hypertension is detected by systematic examination of right cardiac cavities and tricuspid regurgitation flow at echocardiography, and the diagnosis is established by right heart catheterization.

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“…Lung and liver transplantation is considered the definitive treatment for HHT patients 15 , 16 . However, these patients have aberrant vessels, which might impair the stability of vascular anastomosis after transplantation.…”

Section: Discussionmentioning

confidence: 99%

Long‐Term Therapy With Thalidomide in Hereditary Hemorrhagic Telangiectasia: Case Report and Literature Review

Chen

Hsu

et al. 2012

The Journal of Clinical Pharma

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Lung transplantation in a patient with arteriovenous malformations

Cited by 32 publications

References 4 publications

A Second Mitral Valve Replacement in a Patient With Hereditary Hemorrhagic Telangiectasia (Osler's Disease)

A Second Mitral Valve Replacement in a Patient With Hereditary Hemorrhagic Telangiectasia (Osler's Disease)

Pulmonary Vascular Manifestations of Hereditary Hemorrhagic Telangiectasia (Rendu-Osler Disease)

Long‐Term Therapy With Thalidomide in Hereditary Hemorrhagic Telangiectasia: Case Report and Literature Review

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