BACKGROUND Cerebral ischemic stroke is attributed to paradoxical cerebral embolism.Pulmonary arteriovenous fistula(PAVF)is a rare potential cause of cerebral ischemic stroke,and cerebral ischemic stroke induced by PAV...BACKGROUND Cerebral ischemic stroke is attributed to paradoxical cerebral embolism.Pulmonary arteriovenous fistula(PAVF)is a rare potential cause of cerebral ischemic stroke,and cerebral ischemic stroke induced by PAVF in children is rare.CASE SUMMARY We report a case of right PAVF that presented as a transient ischemic attack(TIA)in a 13-year-old boy.The patient underwent embolization therapy and remained clinically stable for 2 years after treatment.CONCLUSION TIA induced by PAVF in children is rare,lacks typical clinical manifestations,and should not be ignored.展开更多
Coronary-pulmonary artery fistula(CPAF)is a relatively rare type of congenital coronary artery variation,which is mostly asymptomatic and is discovered incidentally by coronary artery CT imaging or angiography.However...Coronary-pulmonary artery fistula(CPAF)is a relatively rare type of congenital coronary artery variation,which is mostly asymptomatic and is discovered incidentally by coronary artery CT imaging or angiography.However,CPAF can cause a phenomenon of inter-artery steal and hemodynamic disorders,leading to myocardial ischemia,arrhythmia,heart failure,syncope and even cardiac sudden death in severe cases.Here we reported a case of a 53-year-old female who complained of intermittent palpitations and had a history of paroxysmal atrial fibrillation.The coronary angiography revealed bilateral coronary artery fistulae to pulmonary artery.In this case,the multiple fistulas were very rare and significant.Multidisciplinary treatment should be considered,including cardiologists,surgeons,anesthesiologists and nurses,etc.Regular follow-up is essential for long-term disease management after diagnosis or surgery.展开更多
Objective:to describe the clinical features of bilateral multiple pulmonary arteriovenous fistulas(PAF)with paroxysmal aphasia as the first symptom.Methods:we collected the clinical history and examination data of a p...Objective:to describe the clinical features of bilateral multiple pulmonary arteriovenous fistulas(PAF)with paroxysmal aphasia as the first symptom.Methods:we collected the clinical history and examination data of a patient with paroxysmal aphasia.In order to trace the etiology,we performed chest computed tomography(CT)and pulmonary CT angiography(CIA).Results:the patient had paroxysmal aphasia with dizziness,brain magnetic resonance imaging(MRI)showed cerebral infarction,the transcranial Doppler(TCD)foaming test was positive,transesophageal ultrasound showed no patent foramen ovale,and chest CT and CIA showed bilateral multiple PAF.Conclusion:bilateral multiple PAF are rare in clinic.When patients have paroxysmal neurological symptoms,the possibility of PAF leading to embolism should be considered.展开更多
Systemic arterial to pulmonary vessel fistulas may develop in the setting of pleural inflammation and/or injury.Bronchial arteries are the most commonly involved vessels,with recruitment often occurring in chronic dis...Systemic arterial to pulmonary vessel fistulas may develop in the setting of pleural inflammation and/or injury.Bronchial arteries are the most commonly involved vessels,with recruitment often occurring in chronic diseases such as tuberculosis and cystic fibrosis.Rarely,transpleural systemic arteries that directly communicate with the pulmonary vasculature may develop in the presence of pleural injury or chronic inflammation.The clinical presentation and management of three cases of transpleural systemic artery to pulmonary vessel fistulas are detailed.Given the atypical imaging appearance of these lesions,there is risk of misdiagnosis of these entities as a pulmonary arteriovenous malformation.Understanding the pathophysiology,complex anatomy,and treatment for these rare vascular malformations is crucial prior to angiographic intervention in order to improve outcomes,avoid misdiagnosis,and prevent inappropriate intervention.展开更多
The Vieussens’ arterial ring (VAR) is a rare coronary anomaly that may be associated with a pulmonary fistula, and has been linked to ischemia, myocardial infarction, heart failure, arrhythmias, and sudden death. We ...The Vieussens’ arterial ring (VAR) is a rare coronary anomaly that may be associated with a pulmonary fistula, and has been linked to ischemia, myocardial infarction, heart failure, arrhythmias, and sudden death. We present the case of a 54-year-old man who was admitted to the emergency room with angina and dyspnea on moderate exertion, in the context of atrial fibrillation and decompensated heart failure with left ventricular systolic dysfunction. In the study of its etiology, coronary computed tomography angiography (CCTA) identified an anomalous conal artery outflow (type C) as part of the VAR and a fistula to the pulmonary artery trunk (variant 1b), with an arterial flow linking the conal artery and the middle third of the left anterior descending artery (LAD), which then fistulized to the pulmonary artery trunk. The hemodynamic and clinical repercussions presented with signs of ischemia in the LAD territory and acute heart failure. In this case, CCTA identified the coronary anomaly and its trajectory with great precision through volume rendering reconstruction, as well as the dynamics of coronary flow in the presence of the pulmonary fistula. This anatomical variant is rarely described, and CCTA is of great utility in the therapeutic decision for fistula closure.展开更多
基金Supported by Scientific Research Project of Hainan Provincial Health Industry,China,No.20A200081Clinical Medical Center Project of Hainan Province,China,No.QWYH202175.
文摘BACKGROUND Cerebral ischemic stroke is attributed to paradoxical cerebral embolism.Pulmonary arteriovenous fistula(PAVF)is a rare potential cause of cerebral ischemic stroke,and cerebral ischemic stroke induced by PAVF in children is rare.CASE SUMMARY We report a case of right PAVF that presented as a transient ischemic attack(TIA)in a 13-year-old boy.The patient underwent embolization therapy and remained clinically stable for 2 years after treatment.CONCLUSION TIA induced by PAVF in children is rare,lacks typical clinical manifestations,and should not be ignored.
基金supported by the National Natural Science Foundation of China(No.82100359,No.81273878).
文摘Coronary-pulmonary artery fistula(CPAF)is a relatively rare type of congenital coronary artery variation,which is mostly asymptomatic and is discovered incidentally by coronary artery CT imaging or angiography.However,CPAF can cause a phenomenon of inter-artery steal and hemodynamic disorders,leading to myocardial ischemia,arrhythmia,heart failure,syncope and even cardiac sudden death in severe cases.Here we reported a case of a 53-year-old female who complained of intermittent palpitations and had a history of paroxysmal atrial fibrillation.The coronary angiography revealed bilateral coronary artery fistulae to pulmonary artery.In this case,the multiple fistulas were very rare and significant.Multidisciplinary treatment should be considered,including cardiologists,surgeons,anesthesiologists and nurses,etc.Regular follow-up is essential for long-term disease management after diagnosis or surgery.
基金funded by the Scientific Research Program of the Hubei Provincial Department of Education in 2019(Q20192103)the 2019 National College Students'innovation and Entrepreneurship Training Project(201910929012).
文摘Objective:to describe the clinical features of bilateral multiple pulmonary arteriovenous fistulas(PAF)with paroxysmal aphasia as the first symptom.Methods:we collected the clinical history and examination data of a patient with paroxysmal aphasia.In order to trace the etiology,we performed chest computed tomography(CT)and pulmonary CT angiography(CIA).Results:the patient had paroxysmal aphasia with dizziness,brain magnetic resonance imaging(MRI)showed cerebral infarction,the transcranial Doppler(TCD)foaming test was positive,transesophageal ultrasound showed no patent foramen ovale,and chest CT and CIA showed bilateral multiple PAF.Conclusion:bilateral multiple PAF are rare in clinic.When patients have paroxysmal neurological symptoms,the possibility of PAF leading to embolism should be considered.
文摘Systemic arterial to pulmonary vessel fistulas may develop in the setting of pleural inflammation and/or injury.Bronchial arteries are the most commonly involved vessels,with recruitment often occurring in chronic diseases such as tuberculosis and cystic fibrosis.Rarely,transpleural systemic arteries that directly communicate with the pulmonary vasculature may develop in the presence of pleural injury or chronic inflammation.The clinical presentation and management of three cases of transpleural systemic artery to pulmonary vessel fistulas are detailed.Given the atypical imaging appearance of these lesions,there is risk of misdiagnosis of these entities as a pulmonary arteriovenous malformation.Understanding the pathophysiology,complex anatomy,and treatment for these rare vascular malformations is crucial prior to angiographic intervention in order to improve outcomes,avoid misdiagnosis,and prevent inappropriate intervention.
文摘The Vieussens’ arterial ring (VAR) is a rare coronary anomaly that may be associated with a pulmonary fistula, and has been linked to ischemia, myocardial infarction, heart failure, arrhythmias, and sudden death. We present the case of a 54-year-old man who was admitted to the emergency room with angina and dyspnea on moderate exertion, in the context of atrial fibrillation and decompensated heart failure with left ventricular systolic dysfunction. In the study of its etiology, coronary computed tomography angiography (CCTA) identified an anomalous conal artery outflow (type C) as part of the VAR and a fistula to the pulmonary artery trunk (variant 1b), with an arterial flow linking the conal artery and the middle third of the left anterior descending artery (LAD), which then fistulized to the pulmonary artery trunk. The hemodynamic and clinical repercussions presented with signs of ischemia in the LAD territory and acute heart failure. In this case, CCTA identified the coronary anomaly and its trajectory with great precision through volume rendering reconstruction, as well as the dynamics of coronary flow in the presence of the pulmonary fistula. This anatomical variant is rarely described, and CCTA is of great utility in the therapeutic decision for fistula closure.
