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Closure of a large arteriovenous malformation of the left lung in a patient after Fontan procedure (case report)

Abstract

The development of arteriovenous pulmonary malformations quite often (up to 25% of all cases) occurs when applying a cavopulmonary anastomosis (Glenn procedure) and performing the Fontan procedure. This can be directly related to both the restructuring of hemodynamics in the hepatic segment of the venous system, with subsequent changes in the liver function against this background and the non-entry of hepatic enzymes – antiangiogenic factors into the pulmonary circulation, and the formation of a “non-pulsating” pulmonary blood flow. Endovascular treatment in this case is minimally traumatic and demonstrates high immediate efficiency, however, the long-term outcomes of these interventions have been poorly investigated, with the studied groups of patients being extremely small.

Today, embolization therapy is one of the main treatment options in patients with an arteriovenous malformation, especially when a vascular anomaly is located deep in the lung parenchyma. The proposed method is minimally invasive, relatively easy to perform and yields good results.

Keywords:arteriovenous malformation; Fontan procedure; endovascular closure; embolization

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflict of interest.

Authors’ contribution. Study conception and design – Podzolkov V.P., Petrosian K.V.; data collection and handling – Khakimov Kh.A.; statistical processing – Khakimov Kh.A.; selection, examination and treatment of patients – Sobolev A.V., Dadabaev G.M..; draft manuscript preparation – Podzolkov V.P., Petrosian K.V., Khakimov Kh.A.; manuscript revision – Podzolkov V.P., Petrosian K.V.

For citation: Petrosian K.V., Podzolkov V.P., Dadabaev G.M., Sobolev A.V., Khakimov Kh.A. Closure of a large arteriovenous malformation of the left lung in a patient after Fontan procedure (case report). Angiology and Vascular Surgery. 2022; 28 (4): 74–80. DOI: https://doi.org/10.33029/1027-6661-2022-28-4-74-80 (in Russian)

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Akchurin Renat Suleymanovich

Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, Deputy General Director for Surgery, Head of the Department of Cardiovascular Surgery, National Medical Research Center for Cardiology named after Academician E.I. Chazov, President of the Russian Society of Angiologists and Vascular Surgeons

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.