Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T20:08:53.588Z Has data issue: false hasContentIssue false
  • English
  • Français

Successful use of calcium channel blocker for management of arterio-venous malformations following Fontan procedure

Published online by Cambridge University Press:  29 August 2018

Ramzi Hamzeh ,
Ziad Bulbul  and
Jana Assy
Ramzi Hamzeh
Affiliation:
Department of Pediatric and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Ziad Bulbul
Affiliation:
Department of Pediatric and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Jana Assy*
Affiliation:
Department of Pediatric and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
*
Author for correspondence: J. Assy, Department of Pediatric and Adolescent Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107-2020, Lebanon. Tel: 009611350000; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

In diffuse forms of arteriovenous malformation following Fontan procedure, “classical” medical therapy, inhaled nitric oxide and sildenafil, may play a role, until re-direction of hepatic flow to pulmonary circulation cures it. However, in refractory cases, as reported in our 2-year-old patient, unusual medications such as calcium channel blockers can be tried and continued if patients respond adequately.

Keywords

Arteriovenous malformationsFontanamlodipinehypoxemiaintensive care
Type
Brief Report
Information
Cardiology in the Young , Volume 28 , Issue 12 , December 2018 , pp. 1468 - 1470
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Duncan, BW, Desai, S. Pulmonary arteriovenous malformations after cavopulmonary anastomosis. Ann Thorac Surg 2003; 76: 1759–1766.Google Scholar
2. Mcfaul, RC, Tajik, AJ, Mair, DD, Danielson, GK, Seward, JB. Development of pulmonary arteriovenous shunt after superior vena cava-right pulmonary artery (Glenn) anastomosis. Report of four cases. Circulation 1977; 55: 212–216.Google Scholar
3. Kavarana, MN, Jones, JA, Stroud, RE, Bradley, SM, Ikonomidis, JS, Mukherjee, R. Pulmonary arteriovenous malformations after the superior cavopulmonary shunt: mechanisms and clinical implications. Expert Rev Cardiovasc Ther 2014; 12: 703–713.Google Scholar
4. Carlo, WF, Nelson, DP. Inhaled nitric oxide improves oxygen saturation in children with pulmonary arteriovenous malformations after the Fontan procedure. Pediatr Crit Care Med 2011; 12: e152–4.Google Scholar
5. Pantaleoni, J, Parsapour, K, Kon, A. Inhaled nitric oxide and sildenafil therapy for a pediatric patient with multiple pulmonary arteriovenous malformations. J Pediatr Intensive Care 2015; 2: 181–185.Google Scholar
6. Bhate, S, Rossiter-Thornton, M, Cooper, SG, et al. Use of sildenafil and nitric oxide in the management of hypoxemia owing to pulmonary arteriovenous fistulas after total cavopulmonary connection. J Thorac Cardiovasc Surg 2008; 135: 446–448.Google Scholar
7. Papagiannis, J, Apostolopoulou, S, Sarris, G, Rammos, S. Diagnosis and management of pulmonary arteriovenous malformations. Images Paediatr Cardiol 2002; 4: 33–49.Google Scholar
8. Berkels, R, Taubert, D, Bartels, H, Breitenbach, T, Klaus, W, Roesen, R. Amlodipine increases endothelial nitric oxide by dual mechanisms. Pharmacology 2003; 70: 39–45.Google Scholar
9. Sands, A, Dalzell, E, Craig, B, Shields, M. Multiple intrapulmonary arteriovenous fistulas in childhood. Pediatr Cardiol 2000; 21: 493–496.Google Scholar