[Intraoperative fluid therapy in infants with congestive heart failure due to intracranial pial arteriovenous fistula].
Pial arteriovenous fistula is a rare intracranial congenital malformation (0.1-1: 100,000). It has a high blood flow between one or more pial arteries and drains into the venous circulation. It is usually diagnosed during the childhood by triggering an intracranial hypertension and/or congestive heart failure due to left-right systemic shunt. It is a rare malformation with a complex pathophysiology. The perioperative anaesthetic management is not well established. We present a 6-month-old infant diagnosed with pial arteriovenous fistula with hypertension and congestive heart failure due to left-right shunt. He required a craniotomy and clipping of vascular malformation. Anaesthetic considerations in patients with this condition are a great challenge. It must be performed by multidisciplinary teams with experience in paediatrics. The maintenance of blood volume during the intraoperative course is very important. Excessive fluid therapy can precipitate a congestive heart failure or intracranial hypertension, and a lower fluid therapy may cause a tissue hypoxia due to the bleeding.
Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Universitario Puerta del Mar, Cádiz, España. Electronic address: fcoarronimo@icloud.com.
F J
FJ
Arroyo-Fernández
Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Universitario Puerta del Mar, Cádiz, España.
E
E
Calderón-Seoane
Servicio de Neurocirugía, Hospital Universitario Puerta del Mar, Cádiz, España.
F
F
Rodríguez-Peña
Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Universitario Puerta del Mar, Cádiz, España.
L M
LM
Torres-Morera
D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography; D003399:Craniotomy; D005440:Fluid Therapy; D006333:Heart Failure / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male
Congestive heart failure; Fístula arteriovenosa pial; Insuficiencia cardiaca congestiva; Neuroanaesthesia; Neuroanestesia; Paediatric; Pediátrica; Pial arteriovenous fistula