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Ann Thorac Surg 2009;88:677-680. doi:10.1016/j.athoracsur.2008.12.065
© 2009 The Society of Thoracic Surgeons
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Yong Soo Yun
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Case Reports

Development of Bilateral Diffuse Pulmonary Arteriovenous Fistula After Fontan Procedure: Is There Nonhepatic Factor?

Bo Sang Kwon, MD, Eun Jung Bae, MD*, Gi Beom Kim, MD, Chung Il Noh, MD, Jung Yun Choi, MD, Yong Soo Yun, MD

Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea

Accepted for publication December 18, 2008.

* Address correspondence to Dr Bae, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea (Email: eunjbaek{at}snu.ac.kr).

The cause of pulmonary arteriovenous fistulas after a cavopulmonary anastomosis is not clearly known, but the previous studies regarding their causes have been focused mainly on the hepatic factors. We report two unusual Fontan cases with multiple bilateral pulmonary arteriovenous fistulas. One of them died of progressive hypoxia, and the other underwent multiple coiling. Our cases suggest that potentially lethal diffuse pulmonary arteriovenous fistulas may develop bilaterally in spite of balanced hepatic effluent flow to pulmonary circulation through factors other than a hepatic factor.






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Copyright © 2009 by The Society of Thoracic Surgeons.