Postoperative systemic artery to pulmonary vessel fistula: analysis of three cases.
BACKGROUND
Systemic artery to pulmonary vessel fistulas (SAPVF) occur through pleural adhesions from miscellaneous origin. We report 3 cases of acquired SAPVF that developed late after thoracotomy.


METHODS
There was one pleurectomy for pneumothorax, one sleeve main bronchial resection, and one lower-middle bilobectomy. These SAPVF were discovered 4, 18, and 21 years after surgery.


RESULTS
One patient underwent two unsuccessful embolizations. One patient underwent an unsuccessful attempt at surgical treatment after a previous embolization. Both have persistent SAPVF with minimal clinical discomfort 5 and 13 years later. One patient remains without treatment.


CONCLUSIONS
In the literature 13 cases of SAPVF have been reported after lung resection, pleural drainage, axillary abcess drainage, closed chest trauma, parietal pleurectomy, and talc poudrage. Potential treatments of SAPVF include embolization, resection of pleural adhesion, and artery ligation. The effectiveness of these techniques is uncertain and the follow-up is too short to draw any clear conclusions. Embolization seems to be a useful tool in case of a single afferent artery. Surgical treatment seems to achieve more durable results than embolization but carries a higher risk of bleeding in the case of large SAPVF. Because SAPVF are well tolerated and complications are uncommon, clinical follow-up may be warranted in most cases.
Riehl
Gregory
G
Service de Chirurgie Thoracique, Hôpital A Michallon, Grenoble, France.
Chaffanjon
Philippe
P
Frey
Gil
G
Sessa
Carmine
C
Brichon
Pierre Yves
PY
D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D001366:Axillary Artery; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries; D008875:Middle Aged; D010994:Pleura; D011667:Pulmonary Veins; D011859:Radiography; D013348:Subclavian Artery; D013908:Thoracotomy / Q000009:adverse effects*; D000267:Tissue Adhesions / Q000209:etiology