Pulmonary arteriovenous malformation
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A pulmonary arteriovenous malformation (PAVM) is an abnormal connection between a branch of a pulmonary artery and a pulmonary vein through a thin-walled aneurysmal sac. PAVMs are most commonly congenital in nature and have a strong relationship with the syndrome of hereditary hemorrhagic telangiectasia (HHT). PAMVs act as direct right-to-left shunts and result in dyspnea, fatigue, cyanosis, and/or polycythemia when the shunt is large. Because the PAVM bypasses the capillary bed, the lung loses its filter function, and, thus, paradoxical emboli and bacteria are able to pass directly into the systemic circulation, with the result being or cerebral abscess. Selective embolization is the first-line procedure for the treatment of these malformations and leads to immediate occlusion of the PAVM in 90%–100% of cases and to continued occlusion 1 year after the procedure in more than 80% of cases.
