INCREASED CARDIOPULMONARY EXERCISE PERFOR MANCE AFTER EMBOLIZATION OFAN ARTERIOVENOUS PULMONARY FISTULA

A 21-year-old woman suffering from increasing dyspnoea on intense phys ical exercise, was found to have a congenital right-sided arteriovenou s pulmonary fistula. This was successfully and without complication em bolized using a percutaneously introduced Gianturco wire coil. All sym ptoms disappeared after this procedure. Definite improvement in physic al performance, in comparison with pre-embolization values, was docume nted by spiroergometry as early as two days later (oxygen uptake 1855 vs. 1459 ml/min; anaerobic threshold 920 vs. 790 ml/min; oxygen-pulse 10.6 vs. 8.0 ml/beat; oxygen partial pressure 77.5 vs. 67.6 mmHg; alve olar arterial oxygen difference 33 vs. 44 mm Hg). Further constant sub jective and objective improvement in physical performance was demonstr ated 3 months after embolization. - This case confirms that embolizati on of a pulmonary arteriovenous fistula can rapidly achieve lasting im provement in exercise performance.