Kojima K, Akamatsu H, Sunamori M
Department of Cardiothoracic Surgery, Tokyo Medical and Dental University School of Medicine, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Oct;46(10):1037-40. doi: 10.1007/BF03217870.
We report on a 25-year-old cyanotic man who was diagnosed as having a pulmonary arteriovenous fistula. His chief complaint had been shortness of breath since childhood. Polycythemia (Hb 21.4 g/dl) was detected during a health checkup at his company. A chest X-ray showed an abnormal mass in the left lung. Blood gas analysis showed severe hypoxia with PaO2 of 38.6 mmHg at room air. Angio-CT showed a large aneurysmal lesion at S6 of the left lung with a large feeding artery and vein. Oxygen saturation was 75.2% in the radial artery and 62.5% in the right atrium. The right-to-left shunt ratio was therefore calculated as 62%. The aneurysmal lesion was resected by segmentectomy of the left S6 following division of A6 and V6. After a successful operation, the patient no longer had shortness of breath or cyanosis and blood gas analysis showed PaO2 as 84.3 mmHg at room air. Pulmonary angiography showed no residual shunt lesion.
我们报告一例25岁的发绀男性患者，被诊断为患有肺动静脉瘘。他的主要症状自幼即为呼吸急促。在其公司的一次健康检查中发现了红细胞增多症（血红蛋白21.4 g/dl）。胸部X线显示左肺有异常肿块。血气分析显示严重缺氧，室内空气下动脉血氧分压（PaO2）为38.6 mmHg。血管CT显示左肺S6有一个大的动脉瘤样病变，伴有粗大的供血动脉和静脉。桡动脉血氧饱和度为75.2%，右心房血氧饱和度为62.5%。因此，右向左分流率计算为62%。在切断A6和V6后，通过左S6段切除术切除动脉瘤样病变。手术成功后，患者不再有呼吸急促或发绀症状，血气分析显示室内空气下PaO2为84.3 mmHg。肺血管造影显示无残余分流病变。
