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Alternative NamesArteriovenous malformation - pulmonary
Definition Return to top
Pulmonary arteriovenous fistula is a condition in which an abnormal connection (fistula) develops between an artery and vein in the lungs. As a result, blood passes through the lungs without receiving enough oxygen.
Causes Return to top
Pulmonary arteriovenous fistulas are usually the result of a genetic disease that causes the blood vessels of the lung to develop abnormally. Fistulas also can be a complication of liver disease.
Patients with Rendu-Osler-Weber disease (ROWD) -- also called hereditary hemorrhagic telangiectasis (HHT) -- often have abnormal blood vessels in many parts of the body. These abnormal vessels can be in the lungs, brain, nasal passages, liver, and gastrointestinal organs. This condition is slightly more common in women than in men.
Symptoms Return to top
Many people have no symptoms. When symptoms occur, they can include:
Other possible symptoms include:
Exams and Tests Return to top
Treatment Return to top
A small number of patients who have no symptoms may not need specific treatment. For most patients with fistulas, the treatment of choice is to block the fistula during an arteriogram (embolization).
Some patients may need surgery to remove the abnormal vessels and nearby lung tissue.
Outlook (Prognosis) Return to top
The outlook for patients with HHT is not as good as for those without HHT. It is possible for the condition to come back after blocking the fistula (embolization).
Surgery to remove the abnormal vessels usually has a good outcome, and the condition is not likely to return.
Possible Complications Return to top
Major complications after treatment for this condition are unusual. Complications may include:
When to Contact a Medical Professional Return to top
Call your health care provider if you often have nosebleeds or difficulty breathing, especially if you also have a history of HHT.
Prevention Return to top
Because this condition is often genetic, prevention is not usually possible.
References Return to top
Bernstein D. Other Congenital Heart and Vascular Malformations. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 432.Update Date: 9/13/2008 Updated by: Benjamin Medoff, MD, Assistant Professor of Medicine, Harvard Medical School, Pulmonary and Critical Care Unit, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.