Thoracoscopic Left Upper Lobectomy for Refractory Pulmonary Arteriovenous Malformation

Pulmonary arteriovenous malformations (PAVM) can have potentially serious neurological and cardiac consequences if left untreated. Embolization has supplanted surgical resection as the first line treatment modality. However, this technique is not always successful and carries risks of air embolism, migration of the coil, myocardial rupture, vascular injury, pulmonary hypertension, and pulmonary infarction. The author presents a case of persistent hemoptysis from a left upper lobe PAVM, despite multiple embolizations. The patient, a 38-year-old female with Osler-Weber-Rendu syndrome, underwent a thoracoscopic left upper lobectomy with complete resolution of her symptoms. She was discharged home on day three to take care of her ten children.