TITLE

Clinical course and medical management of neonates with severe cardiac failure related to vein of Galen malformation

AUTHOR(S)
Frawley, G.P.; Dargaville, P.A.; Mitchell, P.J.; Tress, B.M.; Loughnan, P.
PUB. DATE
September 2002
SOURCE
Archives of Disease in Childhood -- Fetal & Neonatal Edition;Sep2002, Vol. 87 Issue 2, pF144
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Neonatal presentation of vein of Galen aneurysmal malformations (VGAMs) with intractable cardiac failure is considered a poor prognostic sign. Interventional neuroradiology with embolisation has been shown to control cardiac failure, but there is a perception that neurological outcome in survivors is poor. Objective: To determine if aggressive intensive care and anaesthetic management of cardiac failure before urgent embolisation can influence morbidity and mortality. Patients: Nine newborns (four boys, five girls) were diagnosed with symptomatic vein of Galen malformations in the neonatal period during the period 1996-2001. Eight developed intractable high output cardiac failure requiring initial endovascular treatment in the first week of life. Results: The immediate outcome after a series of endovascular procedures was control of cardiac failure and normal neurological function in six (66%) patients, one death from intractable cardiac failure in the neonatal period, and two late deaths with severe hypoxic-ischaemic neurological injury (33% mortality). Clinical review at 6 months to 4 years of age showed five infants with no evidence of neurological abnormality or cardiac failure and one child with mild developmental delay (11%). Conclusions: Aggressive medical treatment of cardiac failure and early neurointervention combined with modern neuroanaesthetic care results in good survival rates with low morbidity even in cases of high risk VGAM presenting in the immediate perinatal period with cardiac failure. Systemic arterial vasodilators improve outcome in neonates with cardiac failure secondary to VGAM. Excessive β adrenergic stimulation induced by conventional inotropic agents may exacerbate systemic hypoperfusion.
ACCESSION #
9699931

 

Related Articles

  • Hemodynamic disturbances associated with endovascular embolization in newborn infants with vein of Galen malformation. Wong, F. Y.; Mitchell, P. J.; Tress, B. M.; Dargaville, P. A.; Loughnan, P. M. // Journal of Perinatology;May2006, Vol. 26 Issue 5, p273 

    Objective:To examine hemodynamic changes following endovascular embolization in newborn infants with vein of Galen malformation and severe cardiac failure in the first week of life.Study design:Over a recent 5-year period, nine such infants were identified. In seven of these infants, changes in...

  • Methyldopa withdrawal.  // Reactions Weekly;May2014, Vol. 1503 Issue 1, p29 

    An abstract of the article "Prenatal exposure to methyldopa leading to hypertensive crisis and cardiac failure in a neonate," by J. A. Su and colleagues is presented.

  • Systolic heart murmur as first manifestation of high output heart failure due to the vein of galen malformation. Barajas-Gamboa, Juan S.; Diaz-Perez, Julio A.; Leon-Camargo, Yoana; Gonzalez-Gomez, Carlos A.; Sandoval-Gomez, Cecilia // Archivos de Cardiología de México;jul-sep2012, Vol. 82 Issue 3, p214 

    The vein of Galen aneurysmal malformation (VGAM) is an extremely rare arteriovenous malformation. The VGAM clinical manifestations vary depending on the magnitude of vascular compromise and the age at initial presentation. Neonates typically present with severe congestive heart failure. Here we...

  • An Unusual Cause of Heart Failure in a Newborn. Koehl, George; Riley Jr., Harris D.; Ziai, Mohsen // Clinical Pediatrics;Oct1973, Vol. 12 Issue 10, p626 

    Focuses on a case of heart failure in a newborn. Details of the case.

  • Bilateral Coronary Artery Fistulas and Left Ventricle Noncompaction in a Neonate: Diagnosis and Management. Nguyen, Nguyenvu; Rigsby, Cynthia K.; Gambetta, Katheryn; Kaushal, Sunjay // Pediatric Cardiology;Aug2011, Vol. 32 Issue 6, p815 

    This report describes a neonate with heart failure resulting from bilateral coronary artery fistulas and left ventricle noncompaction. The patient underwent successful surgical ligation of the fistulas.

  • MRI imaging of vein of Galen malformations at Steve Biko Academic Hospital: A mini case series. Davel, Liesel; Smal, Janet; Lockhat, Z. I. // South African Journal of Radiology;Jun2011, Vol. 15 Issue 2, p53 

    The article describes four cases of neonate patients who underwent magnetic resonance imaging (MRI) of Vein of Galen aneurysmal malformations (VOGM) at the Steve Biko Academic Hospital in Gauteng, South Africa. Findings showed that all children exhibited some degree of hydrocephalus and two...

  • "Malignant" Brachial Arteriovenous Fistula in a Newborn Child: A Case Report. Pernot, Claude // Angiology;Sep1979, Vol. 30 Issue 9, p640 

    From the time of birth, a patient a rapidly expanding pulsatile mass in the left upper extremity. The findings are those of multiple AV fistulae; thrill, continous murmur, cutaneous angioma, and rapidly appearing trophic changes. Cyanosis and irreversible heart failure ensued, and the patient...

  • Acute liver failure associated with Coxsackie virus B2 infection in a neonate. Wallot, Michael A.; Auth, Marcus; Voit, Thomas; Dirsch, Olaf; Fiedler, Melanie; Metzger-Boddien, Christoph; Kehle, Johannes; Enders, Gisela // European Journal of Pediatrics;2004, Vol. 163 Issue 2, p116 

    Presents a report on neonatal fulminant liver failure (FLF) associated with Coxsackie virus B2 infection. Association of FLF with enterovirus infection and Coxsackie virus B with neonatal myocarditis and meningitis; Evidence of Coxsackie virus B in the mother and acute enterovirus infection in...

  • Diffuse neonatal hemangiomatosis. Maya, Jonathan; Blanco, Gerardo; Maldonado, Rocío // Boletin Medico del Hospital Infantil de Mexico (Departamento de ;ene/feb2013, Vol. 70 Issue 1, p35 

    Introduction. Diffuse neonatal hemangiomatosis is a rare entity and is a serious disorder in which multiple cutaneous and visceral hemangiomas are widely distributed and sometimes may be fatal. Complications include heart failure, bleeding, and liver failure, among others. Treatment is aimed at...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics