Systemic Artery to Pulmonary Vein Fistula After Right Upper Lobectomy Demonstrated by 4-Dimensional Flow Magnetic Resonance Imaging

The Annals of Thoracic Surgery Manuscript
Authors Antoine Legras MD, MS, Arshid Azarine MD, MS, Bastien Poitier MD, Emmanuel Messas MD, PhD, Françoise Le Pimpec-Barthes MD, PhD

Postoperative systemic artery to pulmonary vein fistula is very rare. In this report, we describe an exceptional condition of both intrapulmonary arteriovenous fistula and systemic artery to pulmonary vein fistula, involving all right hemithoracic systemic arteries, inducing left-to-left shunt. This condition was responsible for heart failure, 24 years after a right upper lobectomy for inflammatory tumor. Investigations included computed tomographic angiographyarteriography, and four-dimensional flow magnetic resonance imaging. Differential diagnosis and management are discussed.