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Successful use of calcium channel blocker for management of arterio-venous malformations following Fontan procedure

Published online by Cambridge University Press:  29 August 2018

Ramzi Hamzeh ,
Ziad Bulbul  and
Jana Assy
Ramzi Hamzeh
Affiliation:
Department of Pediatric and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Ziad Bulbul
Affiliation:
Department of Pediatric and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Jana Assy*
Affiliation:
Department of Pediatric and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
*
Author for correspondence: J. Assy, Department of Pediatric and Adolescent Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon. Tel: 009611350000; E-mail: ja101@aub.edu.lb
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Abstract

In diffuse forms of arteriovenous malformation following Fontan procedure, “classical” medical therapy, inhaled nitric oxide and sildenafil, may play a role, until re-direction of hepatic flow to pulmonary circulation cures it. However, in refractory cases, as reported in our 2-year-old patient, unusual medications such as calcium channel blockers can be tried and continued if patients respond adequately.

Keywords

Arteriovenous malformationsFontanamlodipinehypoxemiaintensive care
Type
Brief Report
Information
Cardiology in the Young , Volume 28 , Issue 12 , December 2018 , pp. 1468 - 1470
Copyright
© Cambridge University Press 2018 

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References

1. Duncan, BW, Desai, S. Pulmonary arteriovenous malformations after cavopulmonary anastomosis. Ann Thorac Surg 2003; 76: 1759–1766.Google Scholar
2. Mcfaul, RC, Tajik, AJ, Mair, DD, Danielson, GK, Seward, JB. Development of pulmonary arteriovenous shunt after superior vena cava-right pulmonary artery (Glenn) anastomosis. Report of four cases. Circulation 1977; 55: 212–216.Google Scholar
3. Kavarana, MN, Jones, JA, Stroud, RE, Bradley, SM, Ikonomidis, JS, Mukherjee, R. Pulmonary arteriovenous malformations after the superior cavopulmonary shunt: mechanisms and clinical implications. Expert Rev Cardiovasc Ther 2014; 12: 703–713.Google Scholar
4. Carlo, WF, Nelson, DP. Inhaled nitric oxide improves oxygen saturation in children with pulmonary arteriovenous malformations after the Fontan procedure. Pediatr Crit Care Med 2011; 12: e152–4.Google Scholar
5. Pantaleoni, J, Parsapour, K, Kon, A. Inhaled nitric oxide and sildenafil therapy for a pediatric patient with multiple pulmonary arteriovenous malformations. J Pediatr Intensive Care 2015; 2: 181–185.Google Scholar
6. Bhate, S, Rossiter-Thornton, M, Cooper, SG, et al. Use of sildenafil and nitric oxide in the management of hypoxemia owing to pulmonary arteriovenous fistulas after total cavopulmonary connection. J Thorac Cardiovasc Surg 2008; 135: 446–448.Google Scholar
7. Papagiannis, J, Apostolopoulou, S, Sarris, G, Rammos, S. Diagnosis and management of pulmonary arteriovenous malformations. Images Paediatr Cardiol 2002; 4: 33–49.Google Scholar
8. Berkels, R, Taubert, D, Bartels, H, Breitenbach, T, Klaus, W, Roesen, R. Amlodipine increases endothelial nitric oxide by dual mechanisms. Pharmacology 2003; 70: 39–45.Google Scholar
9. Sands, A, Dalzell, E, Craig, B, Shields, M. Multiple intrapulmonary arteriovenous fistulas in childhood. Pediatr Cardiol 2000; 21: 493–496.Google Scholar