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1 Cardiology, Thoracic Surgery and Pathology Services, Letterman General Hospital, Presidio of San Francisco, California
Systemic artery-to-pulmonary vessel fistulas are rare; only 28 cases have been previously reported. We describe two additional cases. Since the patients are usually asymptomatic, these anomalies are frequently discovered because of a continuous murmur or an abnormal chest x-ray film which often results in the misdiagnosis of patent ductus arteriosus or conventional pulmonary arteriovenous fistula. The correct diagnosis is established by selective arterial angiography. Most of these anomalies are apparently congenital in origin, but a few are acquired. The mechanism of their development, congenital or acquired, is unknown. If snrgery is performed, the preferred treatment is interruption of the vascular channels and resection of involved lung.
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