Cerebral Arteriovenous Malformation Detected by Newborn Congenital Heart Disease Screen with Echocardiography

Hewitt, Angela; Morrical, Brandon D.; Cetta, Frank

doi:10.1016/j.case.2017.07.010

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…However, high-output cardiac heart failure is the most common presentation of intracranial AVSs in the neonatal period (Fig. 3 ) [ 2 ], with features overlapping to those of congenital heart disorders that characterize the clinical picture: cyanosis, compromised peripheral pulses, and a cardiac murmur (often audible also through the fontanelle) [ 7 , 8 ]. Intracranial AVSs often determine high-output heart failure characterized by increased venous return and increased afterload to the right ventricle (RV), resulting in a distended and non-compliant RV and increased pulmonary blood flow with pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%

Use of levosimendan in hemodynamic management of heart failure in two neonates with intracranial arteriovenous shunts: a case series

Landolfo,

Giliberti,

De Rose

et al. 2023

Ital J Pediatr

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Background The hemodynamic status of newborns with intracranial arteriovenous shunts (AVSs) may be extremely complex. Mini-invasive hemodynamic monitoring through innovative techniques such as Near-Infrared Spectroscopy (NIRS) and Pressure Recording Analytical Method (PRAM) may help in understanding hemodynamics in newborns with AVSs. Levosimendan is a calcium sensitizer and inodilator, and it is known to improve ventricular function, but its use in newborns is limited. In our cases, we evaluated the effect of levosimendan on hemodynamics through NIRS and PRAM. Case presentation Herein, we report the cases of two neonates with intracranial arteriovenous shunts, in whom we used levosimendan to manage cardiac failure refractory to conventional treatment. Levosimendan was used at a dosage of 0.1 mcg/kg/min for 72 h. Combined use of NIRS and PRAM helped in real-time monitoring of hemodynamic effects; in particular, levosimendan determined significant improvement in myocardium contractility as well as a reduction of heart rate. Conclusion In two neonatal cases of AVSs, levosimendan led to an overall hemodynamic stabilization, documented by the combination of NIRS and PRAM. Our results suggest introducing levosimendan as a second-line treatment in cases of severe cardiac dysfunction due to AVSs without improvement using standard treatment strategies. Future prospective and larger studies are highly warranted.

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Section: Discussionmentioning

confidence: 99%

Use of levosimendan in hemodynamic management of heart failure in two neonates with intracranial arteriovenous shunts: a case series

Landolfo,

Giliberti,

De Rose

et al. 2023

Ital J Pediatr

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“…Most of the extensive cerebral AVMs present in neonatal or infantile period with intractable heart failure. [ 2 ] Late presenters manifest with mass effects of AVMs such as ischemia, hemorrhage, and brain atrophy.…”

Section: Discussionmentioning

confidence: 99%

A case of partial anomalous systemic venous drainage and perioperative detection of cerebral arteriovenous malformations

et al. 2021

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We report a case of 8-year-old boy with unexplained desaturation and clubbing. Echocardiography showed anomalous drainage of right superior vena cava into left atrium. He did not have any neurological symptoms preoperatively. Some perioperative observations and subtle postoperative behavioral changes prompted us to investigate him further. He was found to have extensive cerebral arteriovenous malformations and hemiatrophy of brain.

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“…Specifically, in neonates with a large VGAM, the right-to-left shunt can be significant due to elevated pulmonary pressures and right-side volume overload with a high-output shunt. 6 The largest cohort published in 1998 outlined the management of infants with VGAM and congenital cardiac defects (including SVD). 3 In this study, patients were symptomatic from the VGAM in the neonatal period and most required VGAM management prior to cardiac surgical repair due to pulmonary hypertension and the development of heart failure.…”

Section: Discussionmentioning

confidence: 99%

Repair of Sinus Venosus Defect and Anomalous Pulmonary Veins Associated With Vein of Galen Malformation

Anderson

Said

Cetta

2018

World J Pediatr Congenit Heart Surg

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Sinus venosus defect (SVD) is a deficiency in the sinus venosus portion of the atrium, often associated with partial anomalous pulmonary venous connections. In patients with vein of Galen malformation (VGAM), SVD provides a unique challenge with respect to embolization treatment. In our case, the child had percutaneous device closure of the SVD prior to VGAM embolization. Nine years later, he required surgical removal of the SVD device and Warden procedure due to progressive right-sided cardiac enlargement.

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Cerebral Arteriovenous Malformation Detected by Newborn Congenital Heart Disease Screen with Echocardiography

Abstract: Graphical abstract

Cited by 4 publications

References 14 publications

Use of levosimendan in hemodynamic management of heart failure in two neonates with intracranial arteriovenous shunts: a case series

Use of levosimendan in hemodynamic management of heart failure in two neonates with intracranial arteriovenous shunts: a case series

A case of partial anomalous systemic venous drainage and perioperative detection of cerebral arteriovenous malformations

Repair of Sinus Venosus Defect and Anomalous Pulmonary Veins Associated With Vein of Galen Malformation

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