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(Chest. 1970;58:623-626.)
© 1970 American College of Chest Physicians

Pulmonary Arteriovenous Fistulae with Bidirectional Shunting

Roger P. Javier M.D.1; Frank J. Hildner M.D., F.C.C.P.2; and Philip Samet M.D., F.C.C.P.3

1 Division of Cardiology, Department of Internal Medicine, Mount Sinai Hospital of Greater Miami, Miami Beach, and the University of Miami, School of Medicine, Coral Gables, Florida
2 Associate Director, Cardiac Catheterization Laboratory
3 Chief, Section of Cardiology

Pulmonary arteriovenous fistulae and cardiomegaly in a patient with Rendu-Osler-Weber disease is reported with hemodynamic data. Indicator dye dilution curves showed the expected right-to-left shunt and also revealed the unusual coexistence of a probable bronchial artery to distal pulmonary arterial bed fistula, in effect establishing a bidirectional shunt. The cardiomegaly was considered to be secondary to the left-to-right shunt. Partial resection of the fistulae ten years prior to this admission failed to relieve cyanosis and symptoms. Diffuse pulmonary involvement prevented further surgical therapy and medical treatment was recommended.






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Copyright © 1970 by the American College of Chest Physicians.