Pulmonary arteriovenous malformations: lung transplantation as a therapeutic option

Multiple pulmonary arteriovenous malformations (PAVM) constitute an uncommo n cause of respiratory disability. They may lead to severe hypoxaemia via r ight-to-left shunts and are sources of substantial mortality and morbidity. Conservative surgical resection has been proposed as the treatment of choi ce. More recently, percutaneous balloon or coil embolization of the feeding vessels offered an efficacious and safe alternative therapy for patients w hose fistulas are too numerous to excise. This study reports an unusual case of respiratory disability in a patient w ith multiple and microscopic pulmonary arteriovenous malformations who fail ed to respond to embolotherapy and who received a double lung transplantati on with good initial outcome.