Mayoral-Silva A, Bobadilla-Ríos G, Mayoral-Amaya AG

Language: Spanish
References: 1
Page: 137-139
PDF size: 267.40 Kb.

ABSTRACT

Introduction: pulmonary arteriovenous malformations (PAVMs) are true high-flow, low-pressure vascular fistulas without a pulmonary capillary filter. They consist of the union of an artery to a vein through an aneurysmal sac. It is a very rare pathology and is associated with chronic renal failure due to bilateral renal hypoplasia even more. Objective: to describe a clinical case of related living donor kidney transplantation in a patient with bilateral renal hypoplasia and pulmonary arteriovenous fistula, its treatment and evolution. Case presentation: 42-year-old male patient, native and resident of San Baltazar Chichicapam, Oaxaca, peasant occupation, exposed to wood smoke for 40 years. Diagnosed with terminal chronic renal failure in May 2020, presenting with uremic syndrome, for which the cause is being studied, reporting bilateral renal hypoplasia. Systemic arterial hypertension secondary to end-stage renal disease controlled with amlodipine and captopril; he undergoes replacement therapy twice a week for hemodialysis. Within the study protocol, he was referred to pulmonology for hypoxemia, with pulse oximetry of up to 80% without clinical data of chronic hypoxemia, which is why a pulmonary arteriovenous fistula was detected on CT. He referred to interventional cardiology for placement of an arteriovenous Amplatzer for fistula closure, which was resolved satisfactorily and later a related living donor kidney transplant was performed without any complications. He evolved satisfactorily, lowering nitrogen levels from the first twenty-four hours until he was discharged from the hospital on the seventh day. Conclusions: kidney transplant surgery from a living related donor can be performed in patients with pulmonary arteriovenous malformations without any complications, after fistula closure by an interventional procedure with Amplatzer.

REFERENCES

1. Salisbury JP, Piñeyro LM. Malformaciones arteriovenosas pulmonares: Aproximación a una patología poco frecuente a partir de tres casos clínicos. Arch Med Interna [Internet]. 2011; 33 (2): 39-43. Disponible en: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-423X2011000200004&lng=es&tlng=es