Faculty Collaboration Database

Clinical practice variability among paediatric interventional cardiologists assessing pulmonary arteriovenous malformations. Cardiol Young 2025 Nov;35(11):2248-2253

Date

10/10/2025

Pubmed ID

41070438

Pubmed Central ID

PMC12536916

DOI

10.1017/S1047951125110019

Scopus ID

2-s2.0-105018634791 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

BACKGROUND: Single ventricle pulmonary arteriovenous malformations are poorly understood and variably assessed in published literature. To improve our understanding of single ventricle pulmonary arteriovenous malformations and facilitate multi-centre studies, it will be necessary to have uniform clinical practice patterns among paediatric heart institutions.

OBJECTIVES: The aim of this study was to assess paediatric interventional cardiologists' clinical perspectives and practice patterns for diagnosing single ventricle pulmonary arteriovenous malformations.

METHODS: We surveyed paediatric interventional cardiologists using the Congenital Cardiovascular Interventional Consortium listserv. A single survey was distributed electronically with two subsequent reminder emails. Voluntary participants completed the anonymous survey electronically via RedCap.

RESULTS: Among 253 Congenital Cardiovascular Interventional Consortium members, a total of 55 (21.7%) paediatric cardiology interventional attending physicians completed the survey. There was near unanimity (98%) that pulmonary arteriovenous malformations develop due to lack of hepatic vein blood flow to the lungs; however, there was wide variation among practice patterns. A minority (20%) of respondents perform bubble contrast echocardiograms (bubble studies) more than half the time pre-Fontan, whereas many (31%) almost never (< 5% of cases) perform bubble studies pre-Fontan. Most respondents reported that they did not perform bubble studies because results do not impact clinical decision making pre-Fontan (56%) or post-Fontan (60%). Many respondents (49%) do not have a typical volume of agitated saline that they inject for bubble studies.

CONCLUSIONS: Clinical practice patterns vary widely among paediatric cardiology interventionalists. A standardised clinical approach, new diagnostic tools, or both are needed to standardise our field's approach to diagnosing, studying, and treating single ventricle pulmonary arteriovenous malformations.

Author List

Fields J, Boon J, Aldoss O, Foerster SR, Gudausky TM, Spurgin SB, Spearman AD

Authors

Osamah Aldoss MD Professor in the Pediatrics department at Medical College of Wisconsin
Susan Foerster MD Professor in the Pediatrics department at Medical College of Wisconsin
Todd M. Gudausky MD Professor in the Pediatrics department at Medical College of Wisconsin
Andrew Spearman MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Arteriovenous Fistula
Arteriovenous Malformations
Cardiologists
Child
Echocardiography
Female
Humans
Male
Practice Patterns, Physicians'
Pulmonary Artery
Pulmonary Veins
Surveys and Questionnaires