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Anesthetic management of a neonate with vein of Galen aneurysmal malformations and severe pulmonary hypertension
Author(s) -
ASHIDA YUKI,
MIYAHARA HIROMI,
SAWADA HIROHUMI,
MITANI YOSHIHIDE,
MARUYAMA KAZUO
Publication year - 2005
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2005.01471.x
Subject(s) - medicine , anesthetic , pulmonary hypertension , vein , anesthesia , surgery , cardiology
Summary Vein of Galen aneurysmal malformations (VGAMs) are rare congenital vascular malformations and excessive arteriovenous shunt causes intractable congestive high‐output heart failure in the neonate. We report a case of successful staged transcatheter embolizations for a neonate with congestive heart failure and pulmonary hypertension (PH). Heart failure was dramatically relieved as the staged procedure progressed. Although transcatheter embolizations is essential for the treatment, inhaled nitric oxide (iNO) was helpful as a bridge treatment to reduce right‐to‐left shunt before the initial emergency embolization. Endovascular embolization is a less invasive therapy than open cranial surgery and allows hemodynamic stability. Perioperative iNO can be used to manage PH in VGAMs.