Pulmonary Arteriovenous Fistulae Follow-up

Updated: Jan 29, 2015
  • Author: Barry A Love, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Follow-up

Deterrence/Prevention

See Medication for the recommended prophylactic regimen for dental, oral, sinus, and genitourinary, and GI procedures in patients with pulmonary arteriovenous malformations (PAVMs).

  • Amoxicillin 3 g orally (PO) 1 hour or 2 g intravenously (IV) 30 minutes before the procedure, followed by 1.5 g PO/IV hours after the initial dose

  • For patients who are allergic to penicillin, erythromycin 1000 mg PO 2 hours before the procedure, followed by 500 mg PO 6 hours after the initial dose

  • For patients who are allergic to penicillin, clindamycin 300 mg PO 1 hour or 300 mg IV 30 minutes before procedure, followed by 150 mg PO/IV 6 hours after initial dose

The recommended prophylactic regimen for genitourinary and GI procedures includes one of the following:

  • Amoxicillin 3 g PO 1 hour before the procedure, followed by 1.5 g PO 6 hours after the initial dose, plus gentamicin 1.5 mg/kg IV 1 hour before the procedure; this may be repeated 8 hours after the initial dose.

  • For patients who are allergic to penicillin, vancomycin 1 g IV over 1 hour plus gentamicin 1.5 mg/kg IV 1 hour before the procedure; this may be repeated 8 hours after the initial dose.

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Complications

See the list below:

  • Seizure

  • Migraine headaches

  • Transient ischemic attack

  • Cerebral vascular accident

  • Brain abscess

  • Hypoxemia, orthodeoxia

  • Hemothorax

  • Life-threatening hemoptysis

  • Pulmonary hypertension

  • Congestive heart failure

  • Polycythemia

  • Anemia

  • Infectious endocarditis

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Patient Education

Thoroughly educate patients with pulmonary arteriovenous malformations and patients with hereditary hemorrhagic telangiectasia (HHT) about their diagnosis and its clinical implications, complications, and hereditary nature.

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