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      Tratamiento quirúrgico de fístula arteriovenosa pulmonar en telangectasia hemorrágica hereditaria (Enfermedad de Rendu Osler Weber) Translated title: Pulmonary arteriovenous fistula in hereditary hemorrhagic telangiectasia. Report of one case

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          Abstract

          Las Fístulas Arteriovenosas Pulmonares (FAVP son malformaciones vasculares infrecuentes. La Telangectasia Hemorrágica Hereditaria o Enfermedad de Rendu-Osler-Weber (EROW) es una enfermedad hereditaria autosómica dominante que se asocia con frecuencia a dichas malformaciones vasculares pulmonares. Presentamos el caso de una mujer de 16 años con EROW y una FAVP única, sintomática y que comprometía extensamente el lóbulo medio, en quien realizamos tratamiento con cirugía resectiva pulmonar (lobectomía media) y que evolucionó satisfactoriamente con desaparición de la sintomatología.

          Translated abstract

          Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) is an autosomal dominant vascular disease that can be associated with pulmonary arteriovenous fistulas. We report a 16 years old female with an Osler-Weber-Rendu syndrome and a history of frequent episodes of epistaxis since the age of 10 years. A Chest CAT sean performed on that occasion showed an arteriovenous fistula. The patient presented with progressive dyspnea, low arterial oxygen saturation and clubbing of fingers. An echocardiogram and lung perfusion scintigram confirmed the presence a right to left shunt. The patient was subjected to a lobectomy with a good postoperative evolution.

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          Pulmonary arteriovenous malformation.

          Pulmonary arteriovenous malformations (PAVM) are rare pulmonary vascular anomalies. Although most patients are asymptomatic, PAVMs can cause dyspnoea from right-to-left shunt. Because of paradoxical emboli, various central nervous system complications have been described including stroke and brain abscess. There is a strong association between PAVM and hereditary haemorrhagic telangiectasia. Chest radiography and contrast enhanced computed tomography are essential initial diagnostic tools but pulmonary angiography is the gold standard. Contrast echocardiography is useful for diagnosis and monitoring after treatment. Most patients should be treated. Therapeutic options include angiographic embolisation with metal coil or balloon occlusion and surgical excision.
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            Hereditary haemorrhagic telangiectasia.

            Hereditary haemorrhagic telangiectasia (also known as Osler-Weber-Rendu syndrome) is a relatively common, under-recognized autosomal-dominant disorder that results from multisystem vascular dysplasia. It is characterized by telangiectases and arteriovenous malformations of skin, mucosa and viscera. This article summarizes the clinical manifestations and the management of this disorder and its management. This review underscores an urgent need to conduct prospective multicentre studies to develop evidence-based management guidelines for this disease.
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              Pulmonary arteriovenous fistula: presentation, diagnosis, and treatment.

              Pulmonary arteriovenous fistulas (PAVFs) are rare vascular malformations of the lung. There is a strong association with Rendu-Osler-Weber disease. Although most patients are asymptomatic, PAVFs can cause dyspnea from a right-to-left shunt. They can also bleed and result in hemoptysis and hemothorax. Because of paradoxical emboli, various central nervous system complications have been described including stroke, and brain abscess. Currently, spiral computed tomography offers the most practical method for establishing the presence of PAVFs. Most patients should be treated. Therapeutic options include angiographic embolization with metal coils or balloon occlusion and surgical excision. Angiographic treatment has become the mainstay of therapy for most patients during the last decade. It is less invasive and can be repeated easily. Surgery, which usually consists of a conservative lung resection, is associated with low morbidity and a low recurrence rate. Both therapeutic approaches are discussed. The Mayo Clinic surgical experience of the last 20 years for PAVFs is presented.
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                Author and article information

                Journal
                rchcir
                Revista chilena de cirugía
                Rev Chil Cir
                Sociedad de Cirujanos de Chile (Santiago, , Chile )
                0718-4026
                April 2010
                : 62
                : 2
                : 165-168
                Affiliations
                [01] Santiago orgnameInstituto Nacional del Tórax orgdiv1Servicio Médico Quirúrgico Respiratorio orgdiv2Sección de Cirugía de Tórax Chile
                [02] Santiago orgnameUniversidad de Chile orgdiv1Campus Oriente orgdiv2Departamento de Cirugía Chile
                Article
                S0718-40262010000200012 S0718-4026(10)06200200012
                10.4067/S0718-40262010000200012
                12fd9d7b-0b3a-40c9-8590-564d70781f45

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 28 July 2009
                : 19 November 2009
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 4
                Product

                SciELO Chile

                Categories
                CASOS CLÍNICOS

                Telangiectasia hemorrágica hereditaria,Arteriovenous fistula,malformaciones arteriovenosas,Rendu Osler Weber,cirugía torácica,pulmón,dyspnea,Osler-Weber-Rendu syndrome

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