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Unlabelled: Accurate estimation of the Lung Shunt Fraction (LSF) is a standard of care in yttrium-90 ( Y) radioembolization treatment planning to prevent excessive lung irradiation due to arterio-venous shunting in the liver. LSF is assessed using Tc macroaggregated albumin ( Tc-MAA) imaging, but this approach adds risk, complexity, and expense to the treatment planning. This study investigates the potential of Contrast-Enhanced Computed Tomography (CECT) as a non-invasive alternative for LSF estimation.
View Article and Find Full Text PDFShort-term efficacy of right-to-left shunt closure in patients with vestibular migraine.
Front Neurol
December 2024
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China.
Objective: This study aims to evaluate the short-term efficacy of right-to-left shunt closure in vestibular migraine patients, and compare the efficacy between patent foramen ovale (PFO) closure and pulmonary arteriovenous malformation (PAVM) embolization. Additionally, the study identifies factors related to surgical outcomes.
Methods: Forty-one patients with vestibular migraine and medium to large right-to-left shunts underwent surgery: PFO closure, PAVM embolization, or both.
Lung transplantation for diffuse pulmonary arteriovenous malformations associated with juvenile polyposis-hereditary hemorrhagic telangiectasia overlap syndrome: a case report.
Gen Thorac Cardiovasc Surg Cases
December 2024
Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, Japan.
Background: Lung transplantation is a viable lifesaving option for patients with diffuse pulmonary arteriovenous malformations (AVMs). We present a case of diffuse pulmonary AVMs associated with juvenile polyposis and hereditary hemorrhagic telangiectasia (JP-HHT) that was successfully managed by lung transplantation.
Case Presentation: A 19-year-old woman developed severe hypoxemia due to pulmonary AVMs diagnosed at 4 years of age.
A retrospective review of sildenafil in the Australia and New Zealand Fontan registry: indications and treatment responses.
Int J Cardiol Congenit Heart Dis
June 2024
University of Sydney, Sydney, Australia.
Introduction: Rates of morbidity and mortality are high in the setting of Fontan physiology and effective medical therapies are not well-established. Clinical trials assessing phosophodiesterase-5-inhibitors, such as sildenafil, have not demonstrated major benefit in patients with a Fontan-type circulation but have only included stable, well-functioning people.
Methods: We sought to retrospectively characterize the people followed by the ANZ Fontan Registry prescribed sildenafil >30 days post Fontan-surgery.
A Case of Pulmonary Arteriovenous Shunt Diagnosed by Microbubble Test via a Swan-Ganz Catheter.
Cureus
December 2024
Department of Cardiology, Japanese Red Cross Maebashi Hospital, Maebashi, JPN.
When encountering severe hypoxemia that does not respond to oxygen supplementation, it is essential to consider underlying right-to-left shunting. Among various diagnostic approaches, the microbubble test via transthoracic echocardiography (TTE) is a simple, noninvasive method for detecting pulmonary arteriovenous shunts, particularly in hepatopulmonary syndrome (HPS). Although microbubbles are usually administered peripherally, using a Swan-Ganz (SG) catheter to inject microbubbles directly into the pulmonary artery may provide even more definitive diagnostic information.
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