# The chief culprit of intractable hypoxemia: a case report of rare pulmonary arteriovenous fistula complicated with giant hemangioma

## TL;DR

A rare case of pulmonary arteriovenous fistula causing severe hypoxia was successfully treated with interventional therapy, leading to full recovery.

## Contribution

This case report highlights the successful management of a rare PAVF complicated by a giant hemangioma using transcatheter intervention.

## Key findings

- A 71-year-old man with PAVF and giant hemangioma was successfully treated with transcatheter interventional therapy.
- The patient's condition and quality of life improved significantly within three days post-operation and remained stable for four years of follow-up.

## Abstract

Pulmonary arteriovenous fistula (PAVF) is a rare disease, which can lead to the direct return of unoxidized venous blood to pulmonary veins and left heart, resulting in right-to-left shunt leading to hypoxia. Long term, the right-to-left shunt will cause severe pathophysiological changes in the patient’s body and pulmonary circulation, and the prognosis will be poor if PAVF is not treated timely.

Here, we report the case of a 71-year-old man who presented with chest tightness and shortness of breath. After a series of examinations, PAVF and giant hemangioma were diagnosed, which are difficult to operate.Transcatheter interventional therapy was initiated. The patient recovered on the third day after operation and was discharged smoothly. During the long-term follow-up of nearly 4 years after discharge, the general condition and quality of life of the patient basically returned to normal.

PAVF is rare but very important clinical problem. When the clinical manifestations of persistent unexplained hypoxia appear, it is necessary to fully consider the possibility of PAVF. Once the diagnosis of PAVF is clear, timely treatment is recommended to avoid deterioration of the disease and affecting the prognosis.