Pulmonary Arteriovenous Malformation in a Young Man

Abstract

A young man was diagnosed to have pulmonary arteriovenous malformation (PAVM) when he was admitted with COVID infection. He had no respiratory distress but his saturation at room air was 90%. Chest X-ray revealed non-homogenous opacity in left lower lobe (LLL). The heart was structurally normal on 2D echocardiography; the saline bubble study was however positive for extra-cardiac shunt. Computed tomography pulmonary angiography (CTPA) revealed PAVM with well-defined lobulated sac measuring 2.9 × 1.9 × 2.5 cm in lateral basal segment of LLL with segmental branch of left pulmonary artery as feeder vessel and it drained into left pulmonary vein. The patient was managed with percutaneous intervention using Amplatzer Vascular Plug II to occlude the feeder vessel. Post-intervention, patient’s saturation improved to 98% at room air and saline bubble study was negative for extra-cardiac shunt. CTPA at 06 weeks revealed complete thrombosis of the sac.

Keywords

• percutaneous intervention
• pulmonary arteriovenous malformation
• saline bubble study