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Ann Thorac Surg 1998;65:848-849
© 1998 The Society of Thoracic Surgeons

Case Reports

Reversal of Pulmonary Arteriovenous Malformation After Diversion of Anomalous Hepatic Drainage

John Lee, MD, Alan H. Menkis, MD, Herschel C. Rosenberg, MD

Division of Cardiothoracic Surgery, London Health Sciences Centre, Children’s Hospital of Western Ontario, The University of Western Ontario, London, Ontario, Canada
Department of Paediatrics, Children’s Hospital of Western Ontario, The University of Western Ontario, London, Ontario, Canada

Accepted for publication October 24, 1997.

Dr Menkis, London Health Sciences Centre, University Campus, 339 Windermere Rd, London, ON, Canada N6A 5A5.

Pulmonary arteriovenous malformation can occur in up to 25% of patients after a classic Glenn shunt. Although unproven, exclusion of hepatic venous blood from the lungs has been proposed as a possible cause. We present a patient born with anomalous hepatic venous drainage into the left atrium with an intact atrial septum in whom pulmonary arteriovenous malformation developed in childhood. This was reversed after diversion of the hepatic venous drainage to the right atrium, supporting exclusion of hepatic venous flow as the cause of pulmonary arteriovenous malformation. The association with the hepatopulmonary syndrome is discussed.




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