Robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolization

Pulmonary arteriovenous malformations create continuous shunting of unoxygenated blood through the lungs into the systemic circulation. These malformations are asymptomatic if small, but cause serious symptoms as they grow in size. Treatment primarily consists of endovascular embolization; lobectomy...

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Main Authors: Balazs C. Lengyel, MD, Jacob B. Watson, MD, Min P. Kim, MD, Alan B. Lumsden, MD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468428724001898
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author Balazs C. Lengyel, MD
Jacob B. Watson, MD
Min P. Kim, MD
Alan B. Lumsden, MD
author_facet Balazs C. Lengyel, MD
Jacob B. Watson, MD
Min P. Kim, MD
Alan B. Lumsden, MD
author_sort Balazs C. Lengyel, MD
collection DOAJ
description Pulmonary arteriovenous malformations create continuous shunting of unoxygenated blood through the lungs into the systemic circulation. These malformations are asymptomatic if small, but cause serious symptoms as they grow in size. Treatment primarily consists of endovascular embolization; lobectomy is preserved for recurring or endovascularly untreatable cases. We describe a case of a 24-year-old man who was first treated with coil embolization 10 years previously, with complete symptom resolution. However, more recently he noted recurrent exercise intolerance, with shortness of breath and hypoxemia. After repeat re-embolization, a computed tomography scan noted some persistent flow. Given the patient's young age, we considered resection as a definite therapy. The patient underwent an uncomplicated robot-assisted right lower lobectomy. Afterward, his symptoms resolved completely. In selected cases, robotic lobectomy for pulmonary arteriovenous malformation is feasible and safe.
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series Journal of Vascular Surgery Cases and Innovative Techniques
spelling doaj-art-006c7e977ff64436b7f24e182d1d079e2025-08-20T02:49:00ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872024-12-0110610160510.1016/j.jvscit.2024.101605Robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolizationBalazs C. Lengyel, MD0Jacob B. Watson, MD1Min P. Kim, MD2Alan B. Lumsden, MD3Department of Cardiovascular Surgery, DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX; Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Budapest, Hungary; Correspondence: Balazs C. Lengyel, MD, Department of Cardiovascular Surgery, Houston Methodist Hospital, 6565 Fannin St, Houston, TX 77030Department of Cardiovascular Surgery, DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TXDivision of Thoracic Surgery, Department of Surgery, Houston Methodist Hospital, Houston, TX; Department of Surgery and Cardiothoracic Surgery, Weill Cornell Medical College, Houston Methodist Hospital, Houston, TXDepartment of Cardiovascular Surgery, DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TXPulmonary arteriovenous malformations create continuous shunting of unoxygenated blood through the lungs into the systemic circulation. These malformations are asymptomatic if small, but cause serious symptoms as they grow in size. Treatment primarily consists of endovascular embolization; lobectomy is preserved for recurring or endovascularly untreatable cases. We describe a case of a 24-year-old man who was first treated with coil embolization 10 years previously, with complete symptom resolution. However, more recently he noted recurrent exercise intolerance, with shortness of breath and hypoxemia. After repeat re-embolization, a computed tomography scan noted some persistent flow. Given the patient's young age, we considered resection as a definite therapy. The patient underwent an uncomplicated robot-assisted right lower lobectomy. Afterward, his symptoms resolved completely. In selected cases, robotic lobectomy for pulmonary arteriovenous malformation is feasible and safe.http://www.sciencedirect.com/science/article/pii/S2468428724001898Arteriovenous malformationEmbolizationCoilsRoboticPulmonary lobectomy
spellingShingle Balazs C. Lengyel, MD
Jacob B. Watson, MD
Min P. Kim, MD
Alan B. Lumsden, MD
Robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolization
Journal of Vascular Surgery Cases and Innovative Techniques
Arteriovenous malformation
Embolization
Coils
Robotic
Pulmonary lobectomy
title Robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolization
title_full Robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolization
title_fullStr Robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolization
title_full_unstemmed Robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolization
title_short Robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolization
title_sort robotic right lower lobectomy for a persistent large pulmonary arteriovenous malformation following repeated coil embolization
topic Arteriovenous malformation
Embolization
Coils
Robotic
Pulmonary lobectomy
url http://www.sciencedirect.com/science/article/pii/S2468428724001898
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AT minpkimmd roboticrightlowerlobectomyforapersistentlargepulmonaryarteriovenousmalformationfollowingrepeatedcoilembolization
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