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Pulmonary and systemic arteriovenous fistulas in patients with left isomerism

Published online by Cambridge University Press:  19 August 2008

Hiroaki Kawata*
Affiliation:
Department of Cardiovascular Surgery and Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi city, Osaka590–02, Japan
Hidefumi Kishimoto
Affiliation:
Department of Cardiovascular Surgery and Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi city, Osaka590–02, Japan
Seiichiro Ikawa
Affiliation:
Department of Cardiovascular Surgery and Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi city, Osaka590–02, Japan
Takayoshi Ueno
Affiliation:
Department of Cardiovascular Surgery and Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi city, Osaka590–02, Japan
Tohru Nakajima
Affiliation:
Department of Cardiovascular Surgery and Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi city, Osaka590–02, Japan
Futoshi Kayatani
Affiliation:
Department of Cardiovascular Surgery and Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi city, Osaka590–02, Japan
Noboru Inamura
Affiliation:
Department of Cardiovascular Surgery and Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi city, Osaka590–02, Japan
Takeshi Nakada
Affiliation:
Department of Cardiovascular Surgery and Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi city, Osaka590–02, Japan
*
Hiroaki Kawata, M D., Department of Cardiovascular Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi City, Osaka 590–02, Japan. Tel: 81–725–56–1220; Fax 81–725–56–5682

Abstract

Abstract Hepatic venous blood has been thought to play some role as a vasoactive agent in the development of pulmonary arteriovenous fistulas in patients with congenital heart disease. During the last 15 years, we have observed pulmonary arteriovenous fistulas in 3, and systemic arteriovenous fistulas in 2, patients from our 16 cases of left isomerism. During the same period, neither pulmonary nor systemic arteriovenous fistulas were detected among 50 patients with right isomerism. Pulmonary arteriovenous fistulas had developed in the absence of surgery in 1 of the patients. Both pulmonary and systemic fistulas were detected in an another patient, in whom the hepatic venous blood bypassed the pulmonary circulation. The level of somatostatin, which is known to reduce splanchnic blood flow, was high in the systemic venous blood of this patient. Although the mechanism of development of the fistulas has yet to be clarified, we should be aware that not only pulmonary, but also systemic arteriovenous fistulas can be found in patients with left isomerism, even prior to any surgical intervention.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1998

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