Two vascular arteriovenous malformations with left-to-right shunting and right-heart failure in a single patient

International Journal of Cardiology
Jörn TongersMechthild Westhoff-Bleck


Arteriovenous malformations may lead to right-heart failure in cases of hemodynamically significant left-to-right shunting. Here, we report the case of a 37-year-old female who presented with congestive heart failure related to an isolated anomalous connection of the left pulmonary vein to the left brachiocephalic vein (partial anomalous pulmonary venous connection). After successful reconnection to the left appendage and clinical improvement, the patient once again developed progressive signs of heart failure. Several arteriovenous malformations were identified in the liver as the underlying cause of the patient's high-output heart failure, and the patient was retrospectively diagnosed with hereditary hemorrhagic telangiectasia. Target embolization led to right-ventricular remodeling, and persistent clinical improvement. To our knowledge, this is the first report of two rare AV-malformations with left-to-right shunting and progressive right-heart failure in a single individual.


Oct 5, 1995·The New England Journal of Medicine·A E GuttmacherRobert I White
Apr 6, 2000·American Journal of Medical Genetics·C L ShovlinH Plauchu
Sep 28, 2000·The New England Journal of Medicine·G Garcia-TsaoRobert I White
Nov 7, 2003·Lancet·Uichiro FuchizakiKenichi Kobayashi
Jul 22, 2004·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Pinar Bayrak-ToydemirJamie McDonald
Dec 3, 2008·International Journal of Cardiology·Andrew J S Coats

Related Concepts

Congenital Arteriovenous Malformation
Myocardial Failure
Pulmonary Veins
Embolization, Therapeutic
Heart Failure
Congestive Heart Failure
Hereditary Hemorrhagic Telangiectasia
Structure of Left Pulmonary Vein
Left Brachiocephalic Vein

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