Lu Weida, Dai Honggang, Li Yunyi, Meng Xiao
Key Laboratory of Cardiovascular Proteomics of Shandong Province, Department of Geriatric Medicine, Qilu Hospital of Shandong University, Jinan, China.
State Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China.
Front Med (Lausanne). 2024 Sep 19;11:1449496. doi: 10.3389/fmed.2024.1449496. eCollection 2024.
Pulmonary arteriovenous malformations (PAVMs) are direct pulmonary artery-to-vein connections without pulmonary capillaries that result in intrapulmonary right-to-left blood shunts. Although most patients with PAVMs may be entirely asymptomatic, PAVMs can induce a series of complications involving the neurological, cardiovascular, and respiratory systems that can lead to catastrophic and often fatal clinical sequelae. In this study we review the available literature and summarize the reported PAVM-related complications among patients with PAVMs. The reviewed studies included observational studies, case studies, prospective studies, and cohort studies, and we provide an overview of PAVM-related neurological and cardiopulmonary manifestations, including stroke, cerebral abscess, transient ischemic attack, cerebral hemorrhage, migraine, seizure, dizziness, cardiac failure, arrhythmia, myocardial infarction, cough, hypoxemia, dyspnea, respiratory failure, hemoptysis, and hemothorax. Identifying and treating PAVMs before the presentation of major complication is important because this can prevent the occurrence of complications and can result in better outcomes. PAVM patients should thus be better evaluated and managed by a multidisciplinary team because they may be in a treatable phase prior to their condition becoming life-threatening.
肺动静脉畸形（PAVM）是肺动脉与静脉之间的直接连接，中间没有肺毛细血管，导致肺内右向左分流。虽然大多数PAVM患者可能完全没有症状，但PAVM可引发一系列涉及神经、心血管和呼吸系统的并发症，这些并发症可导致灾难性且往往致命的临床后果。在本研究中，我们回顾了现有文献，并总结了PAVM患者中报告的与PAVM相关的并发症。所回顾的研究包括观察性研究、病例研究、前瞻性研究和队列研究，我们概述了与PAVM相关的神经和心肺表现，包括中风、脑脓肿、短暂性脑缺血发作、脑出血、偏头痛、癫痫发作、头晕、心力衰竭、心律失常、心肌梗死、咳嗽、低氧血症、呼吸困难、呼吸衰竭、咯血和血胸。在出现重大并发症之前识别和治疗PAVM很重要，因为这可以预防并发症的发生，并能带来更好的结果。因此，PAVM患者应由多学科团队进行更好的评估和管理，因为在病情危及生命之前，他们可能处于可治疗阶段。
