Pulmonary Arteriovenous Fistulas in Children

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Abstract
ALTHOUGH large series of pulmonary arteriovenous fistulas have been reported in adults,1-5 only 32 cases surgically treated and 12 cases diagnosed postmortem have been reported in children.2,6-8 The paucity of pediatric cases could be due to either (a) lack of awareness of this entity in pediatric practice, or to (b) its latency in children with onset of symptoms in adults. Lack of recognition of this disease is probably the explanation, since in 25% to 50% of the adult cases signs and symptoms have been evident since childhood.2,5 The first autopsy diagnosis of pulmonary arteriovenous fistula was made in 1897, in a 12-year-old boy, by Churton.9 Smith and Horton10 are credited with the first clinical diagnosis in a 47-year-old patient who had been a "blue baby." The first successful surgical treatment was reported by Hepburn and Dauphiner11 and performed by Shenstone12a and Janes12b

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