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Oral Presentation - 57
Pulmonary Arteriovenous Malformation in Pediatric Patients: A Single-Center Experience
E. Andreev, L. Elin, Z. Tramova, R. Garbuzov
Russian Children’s Clinical Hospital, Moscow, Russia
Objective: This study aims to elucidate the surgical management of pulmonary arteriovenous malformation (PAVM) in pediatric patients.
Methods: A retrospective analysis was performed on the medical records of 30 patients diagnosed with PAVM at the Russian Children’s Clinical Hospital from 2012 to 2025. The cohort comprised 16 boys (53.3%) and 14 girls (46.7%), aged between 1 and 17 years, with a mean age of 11.5 ± 4.2 years. Presenting symptoms included dyspnea (10, 33.3%), cyanosis (6, 20%), fatigue (6, 20%), hypoxemia (12, 40%), hemoptysis (3, 10%), epistaxis (2, 6.6%), seizures (1, 3.3%). Diagnosis was confirmed in all patients via contrast-enhanced computed tomography (CT) of the lungs.
Results: Imaging studies indicated that PAVM was predominantly located in the right lung (20, 66.6%), followed by the left lung (8, 26.6%), and multiple lesions were observed in two cases (6.6%). Simple PAVMs were identified in 16 patients (53.3%), whereas complex PAVMs were present in 14 patients (46.6%). Initial therapeutic interventions included percutaneous transcatheter embolization (PTE) in 10 patients (33.3%); among these, five patients (16.6%) with complex PAVM experienced recurrence and subsequently underwent surgical intervention. Surgical procedures included open lobectomy (8, 26.6%), bilobectomy (1, 3.3%), thoracoscopic surgery (TS) lobectomy (4, 13.3%), TS anatomical segmentectomy (S8 right) (1, 3.3%), and TS resection of PAVM (2, 6.6%). In 14 cases (46.6%), PAVMs were identified as smaller than 1.5 cm in diameter and asymptomatic, leading to a management strategy involving dynamic observation and biannual CT imaging.
Conclusions: PTE is recognized as primary treatment modalities for PAVM; however, they are associated with certain complications, including incomplete embolization, recanalization, embolus migration, hemorrhage, persistent arteriovenous fistula, and recurrence. For patients with complex PAVM, surgical resection is associated with improved long-term outcomes. TS is established as a safe and effective technique for the management of complex PAVMs in the pediatric population.