Sundeep Bhatia, MD, John F. Morrison, MD, Thomas C

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Presentation transcript:

Pulmonary Hypertension in the Setting of Acquired Systemic Arteriovenous Fistulas Sundeep Bhatia, MD, John F. Morrison, MD, Thomas C. Bower, MD, Michael D. McGoon, MD Mayo Clinic Proceedings Volume 78, Issue 7, Pages 908-912 (July 2003) DOI: 10.4065/78.7.908 Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 Computed tomographic scan of the abdomen shows a markedly dilated inferior vena cava (arrow) approximately 3.7 cm in diameter. Early opacification and dilatation of the inferior vena cava in the absence of right ventricular failure were indirect evidence of a systemic arteriovenous connection. Mayo Clinic Proceedings 2003 78, 908-912DOI: (10.4065/78.7.908) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 Angiogram shows coils in the lumbar artery (small arrow) that were used to treat the abnormal communication between the left iliac artery and left iliac vein/inferior vena cava (large arrow). Mayo Clinic Proceedings 2003 78, 908-912DOI: (10.4065/78.7.908) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 Examination of the abdomen using computed tomographic angiography protocol with 3-dimensional reconstruction shows moderate dilatation of the superior mesenteric artery (SMA) (arrowhead) and marked dilatation of the superior mesenteric vein (SMV) (arrow) with early contrast appearance in the SMV and portal venous system (not shown), suggesting a distal fistula between the SMA and SMV. Mayo Clinic Proceedings 2003 78, 908-912DOI: (10.4065/78.7.908) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 4 Angiogram shows fistula (arrow) between the distal superior mesenteric artery (SMA) and superior mesenteric vein (SMV). Both artery and vein are dilated. Mayo Clinic Proceedings 2003 78, 908-912DOI: (10.4065/78.7.908) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions