Arterio-venous malformations of the liver in hereditary hemorrhagic telangiectasia (Rendu–Osler–Weber disease) causing right heart failure—Successful treatment with transarterial coil embolization

Abstract

The presented case is a 66-year-old man with known hereditary hemorrhagic telangiectasia who presented with recurrent attacks of supraventricular tachycardia and dyspnoea. Cardiac catheterization revealed high cardiac output with peripheral shunting of about 50%. Three sessions of subsequent transarterial selective coil embolization were performed within 25 days after which no more AVMs were observed angiographically. The patient did not face any complications. Finally, the patient was in very good condition and reported neither tachycardia nor dyspnoea. Over a follow-up period of 12 months there were no biliary complications or recurrence of shunting observed. In summary, transarterial coil embolization of large parts of the hepatic arteries is a potent therapy to reduce the amount of arterio-venous blood shunting causing right heart failure.