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Ischaemic stroke with intact atrial septum – exclude arteriovenous malformations

Published online by Cambridge University Press:  25 January 2013

Friederike Doering ,
Andreas Eicken  and
John Hess
Friederike Doering*
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, München, Germany
Andreas Eicken
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, München, Germany
John Hess
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, München, Germany
*
Correspondence to. Dr med. F. Doering, Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse 36, 80636 München, Germany. Tel: 0049 89 1218 3305; Fax: 0049 89 1218 3333; E-mail: doering-f@web.de
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Abstract

A 44-year-old woman was referred to our centre for interventional cardiac catheterisation. The diagnostic work-up after a preceding ischaemic stroke led to the assumption of a patent foramen ovale due to a positive bubble study. Before the planned percutaneous closure of the patent foramen ovale, we performed a second bubble study, which showed an intact atrial septum. However, after two to three heart cycles bubbles could be detected in the left atrium, assuming a right-to-left shunt of an extracardiac origin most likely in the lung. We therefore performed cardiac catheterisation, yielding a pulmonary arteriovenous malformation in the lower lobe of the right lung. This was successfully closed interventionally by placing a Cook coil, as well as several plugs into the malformation and feeding vessels.

Type
Brief Reports
Information
Cardiology in the Young , Volume 24 , Issue 1 , February 2014 , pp. 145 - 147
Copyright
Copyright © Cambridge University Press 2013 

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References

1. Morier, J, Goncalves-Matoso, V, Michel, P. Multiple pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia complicated by embolic strokes. Arch Neurol 2011; 68: 672.Google Scholar
2. Letourneau-Guillon, L, Faughnan, ME, Soulez, G, et al. Embolization of pulmonary arteriovenous malformations with Amplatzer vascular plugs: safety and midterm effectiveness. J Vasc Interv Radiol 2010; 21: 649–656.CrossRefGoogle ScholarPubMed
3. Hart, JL, Aldin, Z, Braude, P, Shovlin, CL, Jackson, J. Embolization of pulmonary arteriovenous malformations using the Amplatzer vascular plug: successful treatment of 69 consecutive patients. Eur Radiol 2010; 20: 2663–2670.CrossRefGoogle ScholarPubMed
4. Remy-Jardin, M, Dumont, P, Brillet, PY, Dupuis, P, Duhamel, A, Remy, J. Pulmonary arteriovenous malformations treated with embolotherapy: helical CT evaluation of long-term effectiveness after 2–21-year follow-up. Radiology 2006; 239: 576–585.Google Scholar
5. Gupta, S, Faughnan, ME, Bayoumi, AM. Embolization for pulmonary arteriovenous malformation in hereditary haemorrhagic telangiectasia: a decision analysis. Chest 2009; 136: 849–858.Google Scholar
6. Faughnan, ME, Palda, VA, Garcia-Tsao, G, et al. International guidelines for the diagnosis and management of hereditary hemorrhagic telangiectasia. J Med Genet 2011; 48: 73–87.Google Scholar
7. Govani, FS, Shovlin, CL. Hereditary haemorrhagic telangiectasia: a clinical and scientific review. Eur J Hum Genet 2009; 17: 860–871.Google Scholar
8. Shovlin, CL, Guttmacher, AE, Buscarini, E, et al. Diagnostic criteria for hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber syndrome). Am J Med Genet 2000; 91: 66–67.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
9. Kurshid, I, Downie, G. Pulmonary arteriovenous malformation. Postgrad Med J 2002; 78: 191–197.Google Scholar
10. Shovlin, CL, Jackson, JE, Bamford, KB, et al. Primary determinants of ischaemic stroke/brain abscess risks are independent of severity of pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia. Thorax 2008; 63: 259–266.Google Scholar