Severe hemoptysis due to systemic arterio-pulmonary venous fistula with proximal anastomotic pseudoaneurysm after surgery for descending thoracic aneurysm

Abstract

Systemic arterio-pulmonary venous fistula is a very rare disorder. This report describes a case of systemic arterio-pulmonary venous fistula, that presented with hemoptysis, with a concomitant proximal anastomotic pseudoaneurysm after surgery for a descending thoracic aortic aneurysm. Chest computed tomography showed a subpleural nodule in the lower lobe of the left lung with a dilated pulmonary vein. A left inferior phrenic arteriograph demonstrated the dilated artery with a fistula flowing into the pulmonary vein. The patient underwent a left lower lobectomy, and was discharged after an uneventful postoperative course.