Pulmonary Arteriovenous Malformations

Authors:
  • PTPeter B. Terry
    Peter B. Terry
  • RWRobert I. White
    Robert I. White
  • KBKlemens H. Barth
    Klemens H. Barth
  • SKStephen L. Kaufman
    Stephen L. Kaufman
  • SMSally E. Mitchell
    Sally E. Mitchell
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Abstract
Pulmonary arteriovenous malformations can result in severe hypoxemia and dyspnea. We measured pulmonary function, arterial blood gases, and hemodynamics in 10 patients with such malformations. Pulmonary-function tests were normal, but hypoxemia was associated with chronic hyperventilation at rest (mean, 12 liters per minute; mean carbon dioxide tension, 28 mm Hg). With exercise, ventilation increased more than expected for the level of carbon dioxide production. Balloon embolization of 58 of the 71 visible vascular malformations in the 10 patients resulted in an increase in arterial oxygen tension (43 vs. 64 mm Hg; P<0.001) and hemoglobin saturation (79 vs. 92 per cent; P<0.001). Nine patients had improved exercise tolerance.

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