title: Multiple Successful Angioembolizations for Refractory Cardiac Failure in a Preterm with Rapidly Involuting Congenital Hemangioma.
abstract: Rapidly involuting congenital hemangiomas (RICH) are the commonest variety of congenital hemangioma, often diagnosed antenatally as high-flow arteriovenous shunts causing hemodynamic compromise to the fetus. The postnatal management of such patients is often challenging. We present the case of an infant boy who was delivered prematurely at 29 weeks of gestation due to fetal compromise by a RICH, with features of high-output cardiac failure and major systemic hemodynamic steal from peripheral organs. Two early angioembolizations were required to manage his high-output cardiac failure. To our knowledge, this infant is the smallest and earliest newborn case of successful angioembolization for a complex, life-threatening vascular anomaly. We discuss the interventional dilemmas regarding the optimal timing of delivery and early embolization.
authors.affiliation: Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada.
authors.forename: Amitava
authors.initials: A
authors.lastname: Sur
authors.affiliation: Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Interventional Radiology, University of British Columbia, Vancouver, Canada.
authors.forename: Heran
authors.initials: H
authors.lastname: Manraj
authors.affiliation: Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada.
authors.forename: Pascal M
authors.initials: PM
authors.lastname: Lavoie
authors.affiliation: Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Maternal and Fetal Medicine, University of British Columbia, Vancouver, Canada.
authors.forename: Ken
authors.initials: K
authors.lastname: Lim
authors.affiliation: Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Plastic Surgery, University of British Columbia, Vancouver, Canada.
authors.forename: Douglas
authors.initials: D
authors.lastname: Courtemanche
authors.affiliation: Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Cardiology, University of British Columbia, Vancouver, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Brooks
authors.affiliation: Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Albersheim
keywords: RICH; angioembolization; high-output cardiac failure; preterm