Abstract
The patient was a 66-year-old female. In the course of therapy for compression fracture, cyanosis was pointed out. Chest CT scan revealed abnormal vessels in the right S6 sub-pleura and the direct connection between the right A8 and right inferior pulmonary vein. Pulmonary angiography showed shunt flow into the atrium. Perfusion scintigraphy revealed extrapulmonary activity due to the right-to-left shunt and a high-level shunt ratio. The diagnosis of pulmonary arterio-venous fistula was made on the basis of these findings. A right lower lobectomy was performed via video-assisted thoracic surgery. Severe hypoxemia was improved after surgery. The postoperative course was uneventful, and the patient was discharged on the 19th POD.
