Complex pulmonary arteriovenous fistula in mother and daughter: Case report.

RATIONALE

Complex pulmonary arteriovenous fistula (PAVF) is unusual, and even rarer in 2 members of a family. PAVF may not appear on chest X-ray or computed tomography imaging, especially in asymptomatic patients, and therapy is limited. Herein, PAVFs occurring in a mother and daughter are described, with the current standard methods of diagnosis and treatment of PAVF.

PATIENT CONCERNS

A 34-year-old woman and her 13-year-old daughter presented with light cyanosis of the nail beds but were otherwise asymptomatic, and physical examination was unremarkable. Their arterial oxygen saturation levels were low (80-85%).

DIAGNOSES

Angiography led to a diagnosis of PAVF involving the bilateral lung in both women.

INTERVENTIONS

The combined use of coils with occluder (patent ductus arteriosus, or PDA) to obstruct the fistula.

OUTCOMES

After interventional treatment, the patients' arterial oxygen saturation improved rapidly (90-95%). At 6-month follow-up, the patients' symptoms and oxygen saturation were normal.

LESSONS

PAVF is an autosomal dominant disease. Here, the characteristics of the 2 patients were very similar. Using detachable coils and then a PDA occluder is a highly efficient method for treating complex PAVFs.