Surgical treatment of pulmonary arteriovenous malformations

Abstract

Background/aim: Pulmonary arteriovenous malformations (PAVMs) are direct communications between the branches of pulmonary arteries and veins. This study evaluates surgically treated cases of pulmonary arteriovenous malformations.

Materials and methods: We retrospectively examined 41 cases of PAVM that were operated in our clinic between 1995 and 2012. We obtained the clinical, radiological, and surgical data of the patients from their files.

Results: The 41 cases comprised 27 males and 14 females. Their mean age at diagnosis was 39.8 years (range: 9-71). The symptoms were hemoptysis in 28 cases, dyspnea in five, cough in three, and epistaxis in two; three patients were asymptomatic. Twenty-three right and 19 left posterolateral thoracotomies were performed, including one case which was operated bilaterally. Lower lobectomy was performed in 17 patients, lower lobectomy and lingulectomy in two, upper lobectomy in ten, middle lobectomy in two, segmentectomy in seven, and wedge resection in four. Postoperative histopathology was arteriovenous malformation in all cases.

Conclusion: PAVMs are rare clinical conditions. Surgery remains the first choice when embolization treatment cannot be performed or is not successful, in symptomatic and complicated patients with PAVM, and/or in cases where the PAVM diagnosis cannot be established.