Pulmoner arteriyovenöz malformasyonlar

Pulmoner arteriyovenöz malformasyonlar (PAVM), sağ-sol şanta neden olabilen pulmoner arter ile pulmoner venler arasındaki anormal direkt bağlantılardır. Bu malformasyonlar en çok herediter hemorajik telenjiektazi hastalığı ile birlikte görülmektedir. Pulmoner anjiyografi altın standart olmakla beraber, akciğer grafisi, kontraslı bilgisayarlı tomografi ve kontrastlı ekokardiyografi kullanılan diğer tanısal araçlardır. Genellikle ilk tercih edilen tedavi şekli PAVM’lerin afferent arterlerinin embolizasyonudur. Embolizasyonun başarısız olduğu durumlarda, embolizasyona rağmen ciddi kanama gelişen hastalarda, PAVM plevraya açıldığında veya tedavi edilemeyen kontrast madde alerjisi olanlarda ve lezyonları embolizasyon için uygun olmayanlarda PAVM’nin cerrahi rezeksiyon endikasyonu vardır.

Pulmonary arteriovenous malformations

Pulmonary arteriovenous malformations (PAVMs) are abnormal direct connections between the pulmonary artery and pulmonary vein which may result in a rightto- left shunt. Theses malformations mostly present with hereditary hemorrhagic telangiectasia disease. Although pulmonary angiography is the gold standard, chest radiography, contrast enhanced computed tomography and contrast echocardiography are among other diagnostic tools. The initial treatment of choice is usually embolization of the afferent arteries to the PAVMs. Surgical resection of PAVMs is indicated for the patients in whom embolization fails and who develop serious bleeding complication despite embolization and have intrapleural rupture of the PAVM, or untreatable contrast agent allergy and lesions not amenable to embolization.

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