2003 Volume 17 Issue 7 Pages 766-770
A 14-year-old boy was admitted due to recanalization of the pulmonary arteriovenous fistula (AVF). He had received coil embolization therapy for AVF located in the superior segment of the left lower lobe (S6) when he was 8 years old. Computed tomography (CT) on admission showed an AVF 4cm in diameter in S6 and 5mm in the posterior segment of the right upper lobe. Digital subtraction angiogram (DSA) showed 2 drainage veins: the superior segmental tributary of the left inferior pulmonary vein and the left basal pulmonary vein. There were no pathological findings on brain magnetic resonance imaging. We selected surgery instead of embolization, because surgery was judged to be a more effective and more successful treatment than embolization for this recanalized AVF case, on the basis of preoperative examination. Partial resection of the right lung (S2) was initially done under thoracoscopy. Afterwards, he underwent left lower lobectomy because of these findings of the lung: dilatation of the left basal pulmonary vein and widespread dilated vessels on the pleura. Selection of the therapeutic method was very important for successful treatment of a recurrent case after embolization of the AVF.
