Respiratory Surgery Disease: Pulmonary Arteriovenous Fistula

• Status which artery and vein have directly connected each other with no capillary vessel in between.
• Approximately 10% may die in 6 years if no treatment is conducted.

Status which artery and vein have directly connected each other with no capillary vessel in between.

Pulmonary Arteriovenous Fistula is a lung vascular disease which pulmonary artery and pulmonary vein cause abnormal anastomosis. Human body vessel runs from large artery comes out from the heart has branched to small artery, connected to small vein to large vein through capillary vessel, then returned back to the heart.Tissues consume necessary nutrition from blood through the capillary vessel, but abnormal status is the pathological condition of this disease where capillary vessel has missed so that artery and vein has connected directly.

Most of the case is congenital abnormality. It is considered that the cause is normal vessels development has become impaired in fetal life.Generally, no symptoms are common, grows larger as age growing, and most of them are found out at the age of 20 to 40s. It happens to find out as abnormal shadow at chest X-ray, or there is a case where the disease has found when diagnosed at hospital with describing the symptoms like hypoxia or breathing difficulty during exercise which comes along with the increase of arteriovenous fistula shunt blood.

Approximately 10% may die in 6 years if no treatment is conducted.

Diagnosis can be made by chest CT examination or blood vessel contrast examination, but in case disease has found by these tests, it is recommended to get treatment even if no symptoms exist, because if it is left behind it may cause brain infarction or encephaloma.

Treatment is primary made with coil embolization of inflow artery by intravascular catheter, but in case inflow artery is large enough, resection surgery is made also.

Prognosis is generally in good condition, but it is necessary to pay attention since the report says that 11% patient may die in 6 years if no treatment is conducted. Also, the relation between this disease and inherited hemorrhagic telangiectasia is pointed out. In this case, the characteristics are; frequent occurrence of repeated nasal hemorrhage, capillary blood vessel widening of skin mucosa, frequent occurrence of arteriovenous fistula on other part or similar symptoms can be seen in the family members. Hereditary hemorrhagic telangiectasia shows the higher ratio at 70% to 90% in the United States and Europe, but it is not so many, 12 to 18%, in Japan. Recently gene which is considered as cause of the disease has found out so that it grows popular that there have the characteristics between abnormal gene and the symptoms.