Persistent pulmonary hypertension in a neonate with vein of Galen arteriovenous malformation.
Vein of Galen aneurysmal malformation (VGAM) often leads to death in the neonatal period, mainly due to congestive heart failure. Chronic and excessive pulmonary flow in utero and postnatally is attributed to large VGAM and right ventricular overload. We report a male neonate with VGAM complicated by severe heart failure and persistent pulmonary hypertension. Endovascular coil embolization of VGAM was performed, resulting in improvement of congestive heart failure; however, severe persistent pulmonary hypertension led to death 2 days after the embolization. Postmortem examination showed marked right and left ventricular hypertrophy and impressive muscular thickening of intra-alveolar arterioles. Neonatal embolization seems to be beneficial only in babies without suprasystemic pulmonary hypertension. Therefore, early delivery and repair of VGAM should be considered before the onset of persistent pulmonary hypertension.
Su
Wei-Ju
WJ
Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Hsieh
Wu-Shiun
WS
Chou
Hung-Chieh
HC
Peng
Steven Shinn-Forng
SS
Yao
Yu-Tung
YT
Won
Sau-Pin
SP
Tsao
Po-Nien
PN
D006801:Humans; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000473:pathology; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000209:etiology* / Q000473:pathology