PMC5360967_01
Chest wall echocardiography using agitated saline particles in patient 1 showing echocardiographic still image depicting all four chambers before instillation of agitated saline (a), agitated saline filling the right side of the heart (b), and the left side after a few heart beats (c, d).
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fig1
Since his low oxygen saturations were out of proportion to the lung disease on CXR, an agitated saline injection with echocardiography of the left heart structures was performed showing delayed (>3 cardiac cycles) entry of particles into the left atrium from the pulmonary veins (Figure 1).
Cardiac catheterization showing the large pulmonary AVM in right lower lobe in patient 1; baseline angiography (a) and after transcatheter occlusion (b).
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fig2
Through a 6 Fr sheath in the right femoral vein, angiography demonstrated a complex single right lower lobe pulmonary AVM with several large arterial afferent vessels (Figure 2).