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The role of angiogenesis in the development of pulmonary arteriovenous malformations in children after cavopulmonary anastomosis

Published online by Cambridge University Press:  19 August 2008

Blair Marshall ,
Brian W. Duncan  and
Richard A. Jonas
Blair Marshall
Affiliation:
Department of Surgical Research, Children's Hospital, 300 Longwood Avenue, Boston MA, USA
Brian W. Duncan
Affiliation:
Department of Cardiac Surgery, Children's Hospital, 300 Longwood Avenue, Boston MA, USA
Richard A. Jonas*
Affiliation:
Department of Cardiac Surgery, Children's Hospital, 300 Longwood Avenue, Boston MA, USA
*
Richard A. Jonas, MD, Department of Cardiac Surgery, Children's Hospital, Boston, MA 02115. Tel. (617) 355-7930, Fax. (617) 355-6742
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Abstract

Pulmonary arteriovenous malformations are a frequent cause of progressive cyanosis after construction of a cavopulmonary anastomosis. Their formation complicates the management of children with single ventricle physiology after a bidirectional Glenn shunt or the Kawashima procedure. The key role of the liver in this phenomenon is suggested by the observation that providing modifications of the Fontan procedure which permit hepatic venous effluent to reach the pulmonary arterial circulation limit further development of the malformations. In addition, it is known that patients with end-stage hepatic failure develop pulmonary arteriovenous malformations that diminish after liver transplantation. We have begun purification of a factor derived from hepatocyte-conditioned media that is inhibitory for the proliferation of cultured endothelial cells. This substance is heat sensitive, and binds avidly to a copper-containing chromatography column. These clinical observations, and this preliminary experimental work, support the concept that hepatic-derived angiogenic factors may play a role in the development of pulmonary arteriovenous malformations after construction of cavopulmonary anastomoses.

Keywords

Angiogenesispulmonary arteriovenous malformationscavopulmonary anastomosisbidirectional Glenn shuntFontan procedure
Type
Young Investigators Award
Information
Cardiology in the Young , Volume 7 , Issue 4 , October 1997 , pp. 370 - 374
Copyright
Copyright © Cambridge University Press 1997

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References

1.Srivastava, D, Preminger, T, Lock, JE, et al. Hepatic venous blood and the development of pulmonary arteriovenous malformations in congenital heart disease. Circulation 1995; 92:1217–1222.CrossRefGoogle ScholarPubMed
2.Bernstein, H, Brook, MM, Silverman, NH, Bristow, J. Development of pulmonary arteriovenous fistulae in children after cavopulmonary shunt. Circulation 1995; 92[suppl II]:I I309–1314.CrossRefGoogle ScholarPubMed
3.McFaul, RC, Tajik, AJ, Mair, DD, Danielson, GK, Seward, JB. Development of pulmonary arteriovenous shunt after superior vena cava-right pulmonary artery (Glenn) anastomosis. Circulation 1977; 55:212–216.CrossRefGoogle ScholarPubMed
4.Moore, JW, Kirby, WC, Madden, WA, Gaither, NS. Development of pulmonary arteriovenous malformations after modified Fontan operations. J Thorac Cardiovasc Surg 1989; 98:1045–1050.CrossRefGoogle ScholarPubMed
5.Kopf, GS, Laks, H, Stansel, HC, Hellenbrand, WE, Kleinman, CS, Talner, NS. Thirty-year follow-up of superior vena cava-pulmonary (Glenn) shunts. J Thorac Cardiovasc Surg 1990; 100:662–671.CrossRefGoogle ScholarPubMed
6.Knight, WB, Mee, RBB. A cure for pulmonary arteriovenous fistulas? Ann Thorac Surg 1995; 59:999–1001.CrossRefGoogle ScholarPubMed
7.Matsushita, T, Matsuda, H, Ogawa, M, et al. J Am Coll Cardiol 1990; 15:842–848.CrossRefGoogle Scholar
8.Matsuda, H, Kawashima, Y, Hirose, H, Nakano, S, Kishimoto, H, Sano, T. Evaluation of total cavopulmonary shunt operation for single ventricle with common atrioventricular valve and left isomerism. Am J Cardiol 1986; 58:180–182.CrossRefGoogle ScholarPubMed
9.Lamberti, JJ, Spicer, RL, Waldman, JD, Grehl, TM, Thomson, D, George, L, Kirkpatirck, SE, Mathewson, JW. The bidirectional cavopulmonary shunt. J Thorac Cardiovasc Surg 1990; 100:22–30.CrossRefGoogle ScholarPubMed
10.Folkman, J. Clinical applications of research on angiogenesis. N Engl J Med 1995; 333:1757–1763.CrossRefGoogle ScholarPubMed
11.Folkman, J. Tumor angiogenesis. In: Mendelsohn, J, Howley, PM, Esrael, MA, Liotta, LA, eds. The molecular basis of cancer. Philadelphia: W. B. Saunders, 1995:206–232.Google Scholar
12.Marshall, B, Duncan, BW, Hanmin, L, Lock, JE, Jonas, RA. Inhibitory activity of rat hepatocyte conditioned media on endothelial proliferation. Circulation 1996; suppl 94:1–479.Google Scholar
13.Folkman, J, Haudenschild, CC, Zetter, BR. Long-term culture of capillary endothelial cells. Proc Natl Acad Sci (USA) 1979; 76:5217–5221.CrossRefGoogle ScholarPubMed
14.Oliver, MH, Harrison, NK, Bishop, JE, Cole, PJ, Laurent, GJ. Arapid and convenient assay for counting cells cultured in microwell plates: application for assessment of growth factors. J Cell Sci 1989; 92:513–518.CrossRefGoogle Scholar
15.Cloutier, A, Ash, JM, Smallhorn, JF, Williams, WG, Trusler, GA, Rowe, RD, Rabinovitch, M. Abnormal distribution of pulmonary blood flow after the Glenn shunt or Fontan procedure: risk of development of arteriovenous fistulae. Circulation 1985; 72:471–479.CrossRefGoogle ScholarPubMed
16.Jonas, RA. The importance of pulsatile flow when systemic venous return is connected directly to the pulmonary arteries [Letter]. J Thorac Cardiovasc Surg 1993; 105:173–188.CrossRefGoogle Scholar
17.Silverman, A, Cooper, MD, Moller, JH, Good, RA. Syndrome of cyanosis, digital clubbing and hepatic disease in siblings. J Pediatr 1968; 72:70–80.CrossRefGoogle ScholarPubMed
18.Krowka, MJ. Hepatopulmonary syndrome: An evolving perspective in the era of liver transplantation. Hepatology 1990; 11:138–142.CrossRefGoogle ScholarPubMed
19.Barbé, T, Losay, J, Grimon, G, Devictor, D, Sardet, A, Gauthier, J, Houssin, D, Bernard, O. Pulmonary arteriovenous shunting in children with liver disease. J Pediatr 1995; 126:571–579CrossRefGoogle ScholarPubMed
20.Stoller, JK, Moodie, D, Schiavone, WA, Vogt, D, Broughan, T, Winkelman, E, Rehm, PK, Carey, WD. Reduction of intrapulmonary shunt and resolution of digital clubbing associated with primary biliary cirrhosis after liver transplantation. Hepatology 1990; 11:54–58.CrossRefGoogle ScholarPubMed
21.Fewtrell, MS, Noble-Jamieson, G, Revell, S, et al. Intrapul monary shunting in the biliary atresia/polysplenia syndrome: reversal after liver transplantation. Arch Dis Child 1994; 70:501–504.CrossRefGoogle Scholar
22.Aiello, LP, Avery, RL, Arrigg, PG, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 1994; 331:1480–1487.CrossRefGoogle ScholarPubMed
23.Shweiki, D, Itin, A, Soffer, D, Keshet, E. Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis. Nature 1992; 359:843–845.CrossRefGoogle ScholarPubMed
24.Stavri, GT, Hong, Y, Zachary, IC, et al. Hypoxia and platelet-derived growth factor-BB synergistically upregulate the expression of vascular endothelial growth factor in vascular smooth muscle cells. FEES Lett 1995; 358:311–315.CrossRefGoogle ScholarPubMed
25.Folkman, J, Szabo, S, Stovroff, M, McNeil, P, Li, W, Shing, Y. Duodenal ulcer: discovery of a new mechanism and development of angiogenic therapy which accelerates healing. Ann Surg 1991; 214:414–427.CrossRefGoogle ScholarPubMed
26.Li, VW, Folkerth, RD, Watanabe, H, et al. Microvessel count and cerebrospinal fluid basic fibroblast growth factor in children with brain tumours. Lancet 1994; 344:82–86.CrossRefGoogle ScholarPubMed
27.O'Reilly, MS, Holmgren, L, Shing, Y, et al. Angiostatin: A novel angiogenesis inhibitor that mediates the suppression ofmetastases by a Lewis lung carcinoma. Cell 1994; 79: 315–328.CrossRefGoogle Scholar