Management of an asymptomatic pulmonary arteriovenous fistula diagnosed prenatally by detachable balloon embolization: a case report.

BACKGROUND

Pulmonary arteriovenous fistulas (PAVFs) are abnormal vascular malformations that connect pulmonary arteries and pulmonary veins, resulting in a right-to-left shunt. This anatomical shunt leads to a decrease in arterial oxygen saturation. Patients with PAVFs are usually treated with embolization or surgical procedures.

CASE SUMMARY: A 15-month-old child was diagnosed with PAVF in utero at 36 weeks' gestational age. The patient had no history of dyspnoea, repeated haemoptysis, or pneumonia, and there was no relevant family history. A chest computed tomography (CT) scan showed a bilobed opacity located in the inferior lobe of the right lung, and an echocardiogram detected a small atrial septal defect with positive contrast echocardiography. The patient underwent successful embolization using a detachable balloon catheter due to the relatively large diameter of the fistula. After the surgery, a significant decrease in flow was observed in the fistula, and the contrast is no longer visible.

DISCUSSION: Here, we report a case of a paediatric patient with congenital asymptomatic PAVF, diagnosed prenatally, and successfully treated with detachable balloon embolization. The case illustrates the detachable occlusion balloons appear to be an effective tool for embolization of PAVF in children, especially in cases involving large feeding vessels.