Incidental diagnosis of four pulmonary arteriovenous fistulas during patent foramen ovale closure: a case report.
Alessandro AndreisGabriella AgnolettiPaolo ScacciatellaPublished in: Cardiology in the young (2020)
Cryptogenic cerebral ischemia in young patients is commonly ascribed to paradoxical embolism. We report the clinical case of a young patient with cryptogenic stroke and a patent foramen ovale, undergoing percutaneous closure of atrial septal defect. Contrast transoesophageal echocardiography at the end of the procedure demonstrated massive late residual right-to-left shunt, due to the coexistence of pulmonary arteriovenous fistulas that were subsequently closed. Routinary adoption of contrast transoesophageal echocardiography at the end of patent foramen ovale closure interventions may be useful to detect early and late residual shunts. Late residual shunts may be due to pulmonary fistulas, a well-known risk factor for recurrent thromboembolic events.
Keyphrases
- pulmonary hypertension
- cerebral ischemia
- pulmonary artery
- atrial fibrillation
- end stage renal disease
- subarachnoid hemorrhage
- magnetic resonance
- left ventricular
- pulmonary arterial hypertension
- ejection fraction
- newly diagnosed
- minimally invasive
- blood brain barrier
- chronic kidney disease
- left atrial appendage
- brain injury
- middle aged
- contrast enhanced
- magnetic resonance imaging
- electronic health record
- left atrial
- ultrasound guided
- patient reported outcomes