Isolated Pulmonary Arteriovenous Fistula in a Patient with Recurrent Stroke.
Paradoxical embolism is a risk factor for cryptogenic stroke in young adults, and can be primarily attributed to the presence of patent foramen ovale (PFO). Although contrast echocardiography may facilitate diagnosis, it would be difficult to distinguish a PFO from a pulmonary arteriovenous fistula (PAVF), which could also result in paradoxical embolism. We report a 46-year-old woman with recurrent ischemic stroke, who was scheduled for PFO closure because of a right-to-left shunt detected by contrast echocardiography. The diagnosis turned out to be a PAVF confirmed by angiography. Thereafter, coil embolization of this PAVF was performed successfully.


BACKGROUND
Embolic stroke; Patent foramen ovale; Pulmonary arteriovenous fistula; Right-to-left shunt.
Department of Pediatrics, National Taiwan University Hospital;
Chia-Ching
CC
Wang
Department of Pediatrics, National Taiwan University Hospital;
Jou-Kou
JK
Wang
Department of Pediatrics, Buddhist Tzu-Chi General Hospital, Taipei branch, Taipei, Taiwan.
Jui-Yu
JY
Hsu
Department of Pediatrics, National Taiwan University Hospital;
Chun-An
CA
Chen
Department of Pediatrics, National Taiwan University Hospital;
Mei-Hwan
MH
Wu