This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by LUCAS, R. V. Articles by EDWARDS, J. E. Search for Related Content PubMed PubMed Citation Articles by LUCAS, R. V., JR. Articles by EDWARDS, J. E.

(Circulation. 1961;24:1409.)
© 1961 American Heart Association, Inc.

---

Direct Communication of a Pulmonary Artery with the Left Atrium

An Unusual Variant of Pulmonary Arteriovenous Fistula

RUSSELL V. LUCAS JR. M.D.¹; GEORGE W. LUND M.D.¹; JESSE E. EDWARDS M.D.¹

¹ From the Departments of Pediatrics and Pathology, University of Minnesota, Minneapolis, Minnesota, the St. Louis Park Medical Center, Minneapolis, and the Department of Pathology, The Charles T. Miller Hospital, St. Paul, Minnesota.

Direct communication of a pulmonary artery with the left atrium is described and considered a variant of pulmonary arteriovenous fistula.

A 3-year-old girl presented with clinical evidence of a lesion of the central nervous system. The history revealed that she had been cyanotic and had had clubbing of the digits and polycythemia. A rounded mass was noted in the region of the right pulmonary hilus in the posteroanterior thoracic roentgenogram. A pulmonary arteriovenous fistula was suspected, but the patient succumbed with a cerebral abscess before definitive diagnostic studies and therapy were undertaken.

Anatomic examination revealed an unusual variant of pulmonary arteriovenous fistula, namely, direct communication of the right lower pulmonary artery with the left atrium and absence of the middle and lower lobes of the right lung.

It is important that pulmonary arteriovenous fistulas be suspected clinically, since definitive diagnosis and therapy are now possible. While the hemodynamic effects of this type of lesion are usually not severe, untreated patients suffer a high morbidity and mortality through systemic arterial oxygen desaturation, paradoxic embolization, cerebral abscess, and rupture of the fistula.

This article has been cited by other articles:

				U. K. Chowdhury, D. NB, S. S. Kothari, B. Airan, K. G. Subramaniam, and P. Venugopal Right Pulmonary Artery to Left Atrium Communication Ann. Thorac. Surg., July 1, 2005; 80(1): 365 - 370. [Abstract] [Full Text] [PDF]

				K.M. Krishnamoorthy and S. Rao Pulmonary artery to left atrial fistula Eur. J. Cardiothorac. Surg., November 1, 2001; 20(5): 1052 - 1053. [Abstract] [Full Text] [PDF]

				S. Vasudevan, A. Tajmul Hussain, and N. Subramanian Direct Communication of a Pulmonary Artery with Left Atrium Report of a Case with Balloon Occlusion Studies and Successful Correction: A Case Report Angiology, February 1, 1986; 37(2): 136 - 141. [Abstract] [PDF]