Endovascular treatment of congenital portal vein fistulas with the Amplatzer occlusion device

Two patients with symptomatic congenital portal vein (PV) fistulas (one case of PV-right hepatic vein fistula and one case of PV-inferior vena cava fistula) causing hepatopulmonary syndrome (hepatic dysfunction, lung vascular alteration in the form of arteriovenous shunts, and hypoxemia) were successfully treated with the Amplatzer patent ductus arteriosus (PDA) occlusion device. This device was chosen in light of the anatomic characteristics of the vascular malformations and the specific properties of the prosthesis, especially those related to relocation and retrievability when not properly positioned. Embolization with an Amplatzer PDA occlusion device should be considered as a useful therapeutic alternative in the treatment of congenital portal fistulas that can obviate complex surgeries.