Rare surgery performed on nine-year-old girl, child from Buldhana was suffering from Giant Pulmonary AVM

Aurangabad, Dec 20: A non-invasive Endovascular Surgery was performed on a nine-year-old girl suffering from rare Giant Pulmonary Arteriovenous malformation (AVM), at the Cathlab of AIMS Hospital here recently.

The child from Buldhana was suffering from fatigue, shortness of breath (Dyspnea) and cyanotic disease since she was a year old. On examination at AIMS hospital,

she was found to have clubbing of nails, growth retardation and pulmonary bruits on auscultation with O2 Saturation of less than 70%. Her Hb level had shot up to 23 gm% and platelet count dipped to 1.2 lakh.

On 2D Echo study, cardiologist didn’t find any structural abnormality in the heart, but suspected some abnormal shunt of blood possibly due to some vascular fistula. CT Pulmonary Angiography revealed a giant Pulmonary AVM occupying large volume of the left lung with large arterial feeders causing shunting of the blood and all the symptoms.

Dr. Pranav Wanjari (Neuro and Vascular Interventional Radiologist) did pulmonary angiography followed by embolization of the arterial feeders with vascular plug devices supplying this giant complex pulmonary AVM. He performed minimally invasive surgery on the girl under general anesthesia provided by Dr Vilas Manglurkar (Anesthetist).

Post-procedure there was immediate on-table rise in O2 saturation level to > 90 % from <70%. The patient came for follow up with complete resolution in the symptoms with weight gain, resolving clubbing, and other symptoms.

What is AVM?

Pulmonary Arteriovenous malformation (AVM) is an abnormal direct connection between arteries and veins in the lungs without any intervening capillaries reducing the gas exchange resulting in decreased oxygen levels and shortness of breath specially after exertion. These abnormal tangled vessels have weak walls and may spontaneously rupture and cause bleeding into lungs.

Efforts of Dr Wanjari, Dr Prashant More (Vascular Surgeon), Dr Ravi Saware (Paediatrician), Dr Virendra Jaiswal (Director, AIMS Hospital) and AIMS Hospital team are being appreciated by medical fraternity.