Postoperative pulmonary arteriovenous fistula resulting in recurrent cryptogenic stroke

We report on a 66-year-old patient with a history of two cryptogenic strokes and a patent foramen ovale (PFO) who received a transcatheter closure of his PFO in our institution, but shortly after the intervention there was still a relevant right-to-left shunt. The following work-up showed an isolated pulmonary arteriovenous fistula as the real cause for the right-to-left shunt and hence the two strokes.