Massive Systemic-Pulmonary Arterial Shunt Through Multiple Pleural Adhesions

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Abstract
The following case presents well-documented evidence of a massive systemicpulmonary arterial shunt occurring through multiple arterialized adhesions between the wall of the chest and the upper lobe of the left lung. Severe symptoms suggestive of systemic vascular insufficiency and evidence of the shunt disappeared after freeing of the pleuropulmonary adhesions. In all these respects this case is, to our knowledge, unique. Report of a Case A white woman, 34 years old, was admitted to the Ochsner Clinic on Aug. 29, 1956, complaining of "weak spells" of 18 months' duration. In February, 1955, she awoke choking and gasping, and her breathing was rapid and shallow. She was unconscious for 10 minutes, and, on regaining consciousness she felt numb all over. Similar attacks recurred initially at long intervals and then more frequently. In the preceding five months she had had five major attacks, the last occurring 10 days before admission. Subsequent spells

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