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A1533 - Pulmonary Vascular Malformations Taken to Surgical Correction: Experience of a University Hospital in Latin America
Author Block: L. Fernandez1, D. F. Cruz2, M. Velasquez3, L. F. Sua Villegas4, C. S. Leib5, Biomedical Research Group in Thorax; 1Interventional Pulmonology, Fundacion Valle del Lili, Universidad Icesi, Cali, Colombia, 2General Surgery Resident, Fundacion Valle del Lili, Universidad del Cauca, Cali, Colombia, 3Thoracic Surgery, Fundacion Valle del Lili, Universidad Icesi, Cali, Colombia, 4Departament of Pathology and Laboratory Medicine, Fundacion Valle del Lili, Universidad Icesi, Calli, Colombia, 5Medical Research, Fundacion Valle del Lili, Universidad Icesi, Cali, Colombia.
INTRODUCTION Pulmonary vascular malformations (PVM) are rare in the medical literature. There are not any known statistics for this condition given the variety of its presentation; ranging from cases of prenatal death (undiagnosed), newborns and toddlers with ventilatory failure and hemodynamic compromise, infants and teenagers with recurrent pulmonary infections up to completely asymptomatic adults diagnosed incidentally. Diagnosis is performed via prenatal ultrasound for prenatal cases and by means of a computed tomography (CT) scan in the rest of the population. Treatment includes endovascular intervention and surgical excision. Associated complications include alterations in pulmonary hemodynamics, chronic fibrosis, infections and prenatal death. METHODOLOGY An observational, retrospective study was conducted with data obtained from an electronic history in a period of time between 2010 and 2017. This study included pediatric and adult population managed surgically in Fundación Valle del Lili, a university hospital and reference center in Cali, Colombia. Data including patient´s demographics, clinical information, intra-operatory findings, outcomes and early follow-up was collected. RESULTS 8 cases (4 males and 4 females) ranging from the neonatal age to the fifth decade of life were included. 7 patients presented pulmonary sequestration (6 intralobar and 1 extralobar); one of which was included in a scimitar syndrome. 2 of these cases had arteriovenous malformations; 2 other pediatric cases presented an associated congenital cardiomyopathy; and 2 other cases had a mild postoperative complication (Dindo Clavidien I). There were no fatal outcomes in this population. DISCUSSION We indentified that pulmonary sequestration is the most frequent congenital condition in this population that underwent a surgical procedure. The predominant form of presentation was a pulmonary mass associated with non-specific symptoms. Every patient was under the care of a multidisciplinary team that included the areas of pediatric pulmonoly, adult pulmonoly, thoracic surgery, radiology, intensive care, pathology, respiratory therapy and pulmonary rehabilitation in order to estimate the appropriate individual time and the adequate approach for the surgical correction. In this study the rate of complications was minimal and there were no associated mortality cases.