Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Two Case of Pulmonary Arteriovenous Fistula Treatment Depending on the Presence of Pulmonary Hypertension

폐동맥고혈압 동반여부에 따른 폐동정맥루의 치료

  • Huh, Yun Jeong (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Kim, Jeong Tae (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Choi, Jae Young (Department of Pediatrics, Yonsei University College of Medicine)
  • 허윤정 (연세대학교 의과대학 소아과학교실) ;
  • 김정태 (연세대학교 의과대학 소아과학교실) ;
  • 최재영 (연세대학교 의과대학 소아과학교실)
  • Received : 2004.09.01
  • Accepted : 2004.10.07
  • Published : 2005.02.15
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Abstract

Pulmonary arteriovenous fistulas(PAVFs) is a rare disorder that occurs in two to three children per 100,000 population. It is presented as absence of intervening capillary beds between the pulmonary artery and vein with resultant persistent right to left shunt. Other causes include trauma, liver cirrhosis, malignancy and schistosomiasis. It is mostly asymptomatic, but it may present with respiratory difficulty, cyanosis, clubbed fingers induced by right to left shunt or hemoptysis, polycythemia and epistaxis. Major complications, such as brain abscess, brain embolism, paradoxical embolism and subacute infective endocarditis can be devastating, so therapeutic intervention is recommended in all patients. However, removal of low-resistance fistulas can aggrevate pulmonary hypertension, so detection of increased pulmonary pressure is important. We report two patients : One a 42 year-old male with PAVFs treated with coil embolization, and a 42 year-old female who was treated with anticoagulants due to pulmonary hypertension.

폐동정맥루는 폐동맥 고혈압의 유무에 따라 치료가 달라진다. 따라서 폐동정맥루 치료 전 반드시 폐동맥압을 측정하여야 한다. 이에 저자들은 폐동맥 고혈압이 없어 폐동맥 색전술로 치료한 1례와 폐동맥 고혈압이 동반되어 항응고제를 투여하면서 관찰 중인 1례를 보고하는 바이다.

Keywords

References

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