Neonatal congestive heart failure due to a subclavian artery to subclavian vein fistula diagnosed by noninvasive procedures.
Congestive heart failure in the neonate is usually due to intracardiac anomalies or cardiac dysfunction. Extracardiac causes are rare.


METHODS
We report a newborn infant who presented with respiratory distress and cardiomegaly.


RESULTS
Echocardiography identified a dilated right subclavian artery and vein and superior vena cava. Magnetic resonance imaging confirmed a subclavian artery to subclavian vein fistula that was treated with surgical ligation. The infant recovered fully. This case underscores the need for clinical suspicion of fistulous connection in unusual locations in the face of unexplained heart failure in the neonate.


CONCLUSIONS
Echocardiographic and magnetic resonance imaging are effective noninvasive modalities to confirm the diagnosis prior to surgical intervention.
Tatum
Gregory H
GH
Division of Cardiology, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213, USA.
Newman
Beverley
B
Ralphe
J Carter
JC
D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D008026:Ligation; D018810:Magnetic Resonance Angiography; D013348:Subclavian Artery / Q000002:abnormalities*; D013350:Subclavian Vein / Q000002:abnormalities*; D014656:Vascular Surgical Procedures