Congestive heart failure in neonates due to intracranial arteriovenous malformation: Endovascular treatment

Summary Newborns with intracranial arteriovenous malformations and congestive heart failure have an extremely poor prognosis. This report describes two infants with intracranial arteriovenous malformations and severe congestive heart failure successfully treated in the newborn period with endovascular embolization. Both infants had immediate improvement in symptoms and both had second embolization procedures performed. Ventriculoperitoneal shunting was necessary in both children because of progressive hydrocephalus. At follow-up of more than 4 years, neither patient has any sign of congestive heart failure, and one is developmentally normal.Presented at the meeting, Pediatric Cardiology, Havana, Cuba, November 26–30, 1990.     

Transumbilical embolization of hepatic arteriovenous malformation in a neonate with heart failure

A newborn infant presented with severe heart failure due to a large hepatic arteriovenous malformation (AVM). Umbilical artery (UA) access was safely used for immediate diagnosis and for embolization.     

新生儿双侧弥漫性先天性肺动静脉畸形一例

1例新生儿时期发现的双侧弥漫性先天性肺动静脉畸形(PAVM)患儿以难以纠正的发绀为主要临床表现,胸部CT平扫无异常,增强CT提示肺内血管异常,数字减影血管造影术明确诊断PAVM。提示对病因不明的难治性全身低氧血症新生儿,应进行影像学鉴别诊断。     

Neonatal intraventricular hemorrhage due to an intracranial arteriovenous malformation: a case report.

A full-term newborn infant with intraventricular hemorrhage due to a small arteriovenous malformation draining into the vein of Galen is presented. Other reported series are reviewed, and differences between this case and the usual pattern of morbidity are discussed. The use of computerized tomography is demonstrated.     

Neonatal congestive heart failure due to mediastinal cyst

A case is reported of cardio-respiratory failure in a neonate due to the pressure effect of a posterior mediastinal cyst. The plain film and angiographic findings of this lesion are discussed.     

Effects of tolvaptan on congestive heart failure complicated with chylothorax in a neonate

Tolvaptan is an oral vasopressin type 2 receptor antagonist that can be used for heart failure patients with hyponatremia or symptomatic congestion. Although the effects of tolvaptan in adults have been well documented, only limited information is available in children. The case of a neonate with congestive heart failure complicated with chylothorax after palliative surgery for transposition of the great arteries treated with tolvaptan is reported. Slow up‐titration to 0.1 mg/kg successfully increased urine output and improved refractory congestive heart failure without hypernatremia. Subsequently, bodyweight and chylothorax decreased gradually. Moreover, the use of tolvaptan reduced the dosage of furosemide. Tolvaptan could be an alternative drug for neonates with congestive heart failure. Further large studies are needed to confirm the efficacy and identify the appropriate dose of tolvaptan in neonates.     

Response to prostaglandin E1 in neonates with intracranial arteriovenous malformation treated for suspected congenital heart disease

Summary Two neonates with cardiovascular symptoms associated with intracranial AVM were initially considered to have ductal-dependent congenital heart disease. Prostaglandin E₁ (PGE₁) infusion, initiated to achieve patency of the ductus arteriosus, produced improved oxygenation and cardiovascular status in both infants. Other vascular effects of PGE₁, including pulmonary and extracranial systemic vasodilation, likely accounted for these unique observations in the infants with intracranial AVM. Not only may the signs and symptoms of congenital heart disease be imitated by intracranial AVM, but improved oxygenation and cardiovascular status with PGE₁ infusion used for suspected congenital heart disease may be observed as well.     

Captopril induced reversible acute renal failure in a premature neonate with double outlet right ventricle and congestive heart failure

Background  

Captopril is well tolerated in most patients. There is no report of acute deterioration in renal function after administration of captopril in neonates with congestive heart failure secondary to congenital heart defects with large left-to-right shunts.     

Congenital chylothorax and pulmonary hypertension complicated with heart failure and hepatopathy

Respiratory difficulty resulting from congenital chylothorax is usually relieved by postnatal thoracentesis, closed chest drainage, and oxygen therapy. However, early occurrence of congenital chylothorax or accumulation of a large amount of chylous fluid sometimes leads to pulmonary hypoplasia or persistent pulmonary hypertension of the newborn, which requires further customized mechanical ventilatory support. In these cases, conventional mechanical ventilation is primarily used during initial treatment and is later replaced by high‐frequency ventilation, but the advantages of inhaled nitric oxide treatment have rarely been described. This case suggests the benefits of inhaled nitric oxide in patients with congenital chylothorax, even when mechanical ventilation cannot improve respiratory distress because of severe pulmonary hypertension of the newborn leading to right cardiac dysfunction and possibly cholestasis.     

Fetal congestive heart failure due to nodal tachycardia: in utero digoxin therapy

The authors report one case of fetal congestive heart failure secondary to nodal tachycardia, revealed in the 26th week of gestation. Transplacental digoxin treatment stopped the tachycardia in a few days and allowed the pregnancy to continue to term, with delivery of a normal child. This report shows the value of fetal echocardiography in cases with arrhythmias, the possibility of in utero digoxin treatment of supraventricular tachycardia and the follow-up procedures.