Pulmonary arteriovenous fistula. Apropos of 12 cases

Arteriovenous fistula of the lung is a relatively rare lesion with various clinical manifestations. It may be clinically silent and discovered by chance on X-ray films of the chest or during evaluation of Rendu-Osler-Weber disease with which it is associated in about one-half of the cases. It may also have loud manifestations when complicated. The fistula is diagnosed in successive steps, mainly by respiratory function tests and pulmonary angiography. Conservative treatment should be the rule, especially in case with multiple fistulae, but it must begin at an early stage to avoid the dramatic complications of this abnormality, such as acute neurological disorders, haemoptysis, haemothorax, etc. Wide and crippling lung resection must be avoided. Aneurysmorrhaphy or embolization is sufficient to cure most of these multiple angiomas. The results obtained are measured by calculating the blood flow rate in the shunt, as it should theoretically disappear after surgery.