title: Persistent pulmonary hypertension in a neonate with vein of Galen arteriovenous malformation.
abstract: 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.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Wei-Ju
authors.initials: WJ
authors.lastname: Su
authors.forename: Wu-Shiun
authors.initials: WS
authors.lastname: Hsieh
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Chou
authors.forename: Steven Shinn-Forng
authors.initials: SS
authors.lastname: Peng
authors.forename: Yu-Tung
authors.initials: YT
authors.lastname: Yao
authors.forename: Sau-Pin
authors.initials: SP
authors.lastname: Won
authors.forename: Po-Nien
authors.initials: PN
authors.lastname: Tsao
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000473:pathology; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000209:etiology* / Q000473:pathology