case_images: PMC5803985_01
case_images: Aortic angiography in lateral (a) and posteroanterior (b) views showing a small tubular AD (asterisk) and tiny systemic-to-pulmonary collaterals (white arrow) causing moderate left-to-right shunt that resulted in significant pulmonary artery opacification. Multiple, tortuous fistulous channels were faintly imaged within in the lower lobe of the left lung possibly due to their "suction" effect. Ao: Aorta, LPA: Left pulmonary artery, PA: Pulmonary artery
case_images: APC-11-89-g001.jpg
case_images: PMC5803985_01_APC-11-89-g001.jpg
case_images: F1
case_images: AD. At cardiac catheterization, a small conical PDA (minimal diameter 2.1 mm, length 7.0 mm) and several tiny systemic-to-pulmonary collaterals were imaged [Figure 1]. In addition, multiple PAVMs completely filling the lower lobe and the posterior segments of the upper lobe lung were faintly imaged at aortic angiography [Figure 1b].
case_images: (a) Aortic angiography after closure of both AD and aortopulmonary collateral with an ADO II-AS (asterisk) and a AVP Type IV (double asterisk), respectively. (b) After the disappearance of the left-to-right shunt, multiple, large fistulous pulmonary arteriovenous communications (white arrows) became evident angiographically and clinically. Ao: Aorta, LPA: Left pulmonary artery
case_images: APC-11-89-g002.jpg
case_images: PMC5803985_01_APC-11-89-g002.jpg
case_images: F2
case_images: Paul, MN, USA), respectively [Figure 2].
case_images: Pulmonary angiography in posteroanterior (a) and lateral (b) views showing the complete disappearance of the right-to-left shunt at the left lung lower lobe after deployment of several AVP Type IV devices. Ao: Aorta, LPA: Left pulmonary artery
case_images: APC-11-89-g003.jpg
case_images: PMC5803985_01_APC-11-89-g003.jpg
case_images: F3
case_images: Overall the PAVMs were closed with 17 Amplatzer Vascular Plugs (two AVP Type II and fifteen AVP Type IV) [Figure 3].