Development of a Pulmonary Arteriovenous Fistula after a Modified Glenn Shunt in Tetralogy of Fallot and Its Resolution after Shunt Takedown in a 57-Year-Old Patient

Abstract

Pulmonary arteriovenous fistula (PAVF) is a complication of the Glenn shunt. A 57-year-old tetralogy of Fallot (TOF) patient, who had undergone a Glenn shunt and TOF total correction, complained of dyspnea and cyanosis. P AVFs w ere present i n the rig ht l ung, and rig ht l ung perfusion was nearly a bsent. A fter c oil embolization, t akedown of the G lenn s hunt, a nd r econstruction of t he rig ht pulmonary a rtery, the p atient’s s ymptoms were relieved. Extrapulmonary radioisotope uptake caused by the PAVFs shown in lung perfusion scans decreased, and right lung perfusion increased gradually. Although the development and resolution of PAVFs after a Glenn shunt have been reported in the pediatric population, this may be the first report on this change in old age.

Keywords

• Fontan procedure
• Hepatopulmonary syndrome
• Pulmonary arteriovenous fistula
• Tetralogy of Fallot
• Angiogenesis inhibitor