Key result
Transcatheter closure using a 22-mm Amplatzer Vascular Plug 2 via an 8.5-F deflectable sheath safely treated congenital descending aorta-pulmonary vein fistula in 1 young man.
Why the study?
Congenital descending aorta-pulmonary vein fistula is an exceedingly rare vascular malformation creating a high-pressure left-to-left shunt that most commonly presents as recurrent hemoptysis.
Case Report (n=1)
No
Congenital descending aorta-pulmonary vein fistula in an adult presenting with recurrent hemoptysis can be safely treated via transcatheter closure using a vascular plug and a deflectable sheath as an alternative to surgery.
Answers are grounded in this paper and cite their sources.
May support transcatheter closure in select rare fistulas with recurrent hemoptysis; leaves open durability and generalizability.
BACKGROUND: Congenital descending aorta-pulmonary vein fistula is an exceedingly rare vascular malformation creating a high-pressure left-to-left shunt, most commonly presenting as recurrent hemoptysis. CASE SUMMARY: A young man presented with a 2-year history of recurrent hemoptysis. Echocardiography revealed turbulent high-velocity flow entering the left atrium via a dilated left inferior pulmonary vein. Computed tomography angiography confirmed an anomalous fistulous vessel from the descending thoracic aorta to the left inferior pulmonary vein. Transcatheter closure was performed using an Amplatzer Vascular Plug 2 (22 mm) delivered through an 8.5-F deflectable sheath, after conventional catheter systems failed because of the acute angle of the fistula origin. DISCUSSION: Congenital descending aorta-pulmonary vein fistula (cDAPVF) must be distinguished from pulmonary sequestration and pulmonary arteriovenous malformation. This is one of the first reported transcatheter closures of cDAPVF in an adult. TAKE-HOME MESSAGES: cDAPVF should be considered in young adults with unexplained recurrent hemoptysis. It can be safely treated with transcatheter device closure using a deflectable sheath and AVP2 (Amplatzer Vascular Plug 2) as an alternative to surgery.
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Aggarwal et al. (2026) conducted a case report in Congenital descending aorta-pulmonary vein fistula causing recurrent hemoptysis (n=1). Transcatheter closure using a 22-mm Amplatzer Vascular Plug 2 delivered through an 8.5-F deflectable sheath was evaluated on Successful transcatheter fistula closure. Transcatheter closure using a 22-mm Amplatzer Vascular Plug 2 via an 8.5-F deflectable sheath safely treated congenital descending aorta-pulmonary vein fistula in 1 young man.
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