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Shqiptar Demaci



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    P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.15-13 - Surgical Management of Huge Pulmonary Arteriovenous Malformations: Our Experience (ID 11125)

      12:00 - 13:30  |  Author(s): Shqiptar Demaci

      • Abstract
      • Slides

      Background

      Pulmonary arteriovenous malformations are rare lesions with significant clinical complications. These lesions are commonly seen in patients with hereditary hemorrhagic telangiectasia (formerly Osler-Weber-Rendu syndrome). Formerly called Osler-Weber-Rendu, HHT is an inherited disorder of the vasculature associated with AVMs and telangiectasias. The prevalence of HHT is 1 in 5,000 to 10,000 patients.) are present, the diagnosis is definite. If two criteria are present, the diagnosis of HHT is probable. If less than two criteria are present, the diagnosis is unlikely.Management of arteriovenous malformations (AVMs) remains challenging because of their unpredictable behavior and with high risk mortality. A multidisciplinary approach based on a new classification scheme and improved diagnostic techniques may improve their management.

      Objectives:The purpose of this study was to review our surgical experience with surgical to manage arteriovenous malformations (AVMs).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We diagnosed a 1 patient A. female birthday 02.09.1990 with pulmonary arteriovenous malformacion (PAVMs) .She has been admitted to the thoracic surgery clininic in QKUK Pristine in July 2015 with massive hemoptisis. Unknwn initially diagnose .She was presented to QKUK hospital urgently with such clinical signs, epistaxis ,cough, hemopstisi, weakness, sweat, fever, dyspnoea, thoracic malaiseand ,massive right hemothorax with clinical signs of hemorrhagic shock with massive hemoptisi, tachycardia, weak pulse, hypotension, severe anemia et hypovolemiv shock .She was treated with right pleural drainage (avarage 2000ml)and intensive therapy et hemotransfusion (8 flacons).She was treated initially with intensive therapy and hemotransfuzion and after that with hemodynamic parameters stable were treated with surgery.Pacient were completed with all the necessary of emergency examinations as thoracic radiography, biochemical examinations, CT scaner toracal, MRI ,Bronchoscopy, EKG ,cardiac echo and cateterisation ,gaseous exchange . The patient continued with the above-mentioned concerns with dyspnoea epistaxis from time to time. Cyanosis of the lips, fingers in the hands of drumsticks, petekie and ecimosis in the skin and mucous membranes, sleep disorders. After 1.5 years it is re-examined in the cardiology clinic "Nene Hospital Theresa "and is diagnosed with giant dexter pulmonary arteriovenous fistule by Pulmonary angiography..She was treated by surgical approach in 10.06.2016 .Right posterolateral thoracotomy ,segmentectomy IV-r and fistul artereovenosectomy ,pleural deainage.

      4c3880bb027f159e801041b1021e88e8 Result

      Arteriovenous malformation size ranged. to 10x 8 cm located in the right lung middle lobe.She was treated by anatomical 4-th segmentectomy. Operator and post operative period is good. Clinical and imaging image of ultimate control is smooth.No mortality ,no major complication.Hospital days stay was 5 days.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Diagnosis and management of AVMs by surgical therapy resection was with very good results and with limited morbidity and low mortality and no recurrence during early follow-up.

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