Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-25T05:26:22.741Z Has data issue: false hasContentIssue false
  • English
  • Français

Early echocardiographic predictor of heart failure in cerebral arteriovenous malformations

Published online by Cambridge University Press:  08 April 2016

Poonam P. Thankavel  and
Claudio Ramaciotti
Poonam P. Thankavel*
Affiliation:
Department of Pediatrics, Division of Cardiology, UT Southwestern Medical Center at Dallas and Children’s Medical Center of Dallas, Dallas, Texas, United States of America
Claudio Ramaciotti
Affiliation:
Department of Pediatrics, Division of Cardiology, UT Southwestern Medical Center at Dallas and Children’s Medical Center of Dallas, Dallas, Texas, United States of America
*
Correspondence to: P. P. Thankavel, MD, Department of Pediatrics, Division of Pediatric Cardiology, UT Southwestern Medical Center, Children’s Medical Center of Dallas, 1935 Medical District Drive Dallas, TX 75235, United States of America. Tel: 214 456 2327; Fax: 214 456 8066; E-mail: poonam.punjwani@childrens.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Neonatal congestive heart failure in cerebral arteriovenous malformations carries a high risk of mortality. Severe heart failure leading to end-organ dysfunction may be a contraindication to early intervention. Although echocardiographic markers of haemodynamic instability exist, an objective echocardiographic predictor of severe heart failure is not available. We present a ratio of antegrade to retrograde flow in the aortic arch that objectively identifies those at the highest risk of mortality. This measurement can be easily obtained and has prognostic value at presentation, before clinical deterioration. Outcomes remain poor even when early intervention is offered, which may reflect irreversible neurological abnormalities.

Keywords

Arteriovenous malformationcongestive heart failureprognostic marker
Type
Brief Reports
Information
Cardiology in the Young , Volume 26 , Issue 5 , June 2016 , pp. 1008 - 1012
Check for updates
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Pellegrino, PA, Milanesi, O, Saia, OS, et al. Congestive heart failure secondary to cerebral arterio-venous fistula. Childs Nerv Syst 1987; 3: 141–144.Google Scholar
2. Hendson, L, Emery, DJ, Phillipos, EZ, et al. Persistent pulmonary hypertension of the newborn presenting as the primary manifestation of intracranial arteriovenous malformation of the vein of Galen. Am J Perinatol 2000; 17: 405–410.Google Scholar
3. Chevret, L, Durand, P, Alvarez, H, et al. Severe cardiac failure in newborns with VGAM: prognosis significance of hemodynamic parameters in neonates presenting with severe heart failure owing to vein of Galen arteriovenous malformation. Intensive Care Med 2002; 28: 1126–1130.CrossRefGoogle ScholarPubMed
4. Gold, AP, Ransohoff, J, Carter, S. Vein of Galen malformation. Acta Neurol Scan 1964; 11: 5–31.Google Scholar
5. Holden, AM, Fyler, DC, Shilito, J, et al. Congestive heart failure from intracranial arteriovenous fistula in infancy. Pediatrics 1972; 49: 30–39.Google Scholar
6. Lasjaunias, P, Rodesch, G, Terbrugge, K, et al. Vein of Galen aneurysmal malformations. Report of 36 cases managed between 1982 and 1988. Acta Neurochir 1988; 99: 26–37.Google Scholar
7. Garcia-Monaco, R, De Victor, D, Mann, C, et al. Congestive cardiac manifestations from cerebrocranial arteriovenous shunts: endovascular management in 30 children. Childs Nerv Syst 1991; 7: 48–52.CrossRefGoogle ScholarPubMed
8. Geibprasert, S, Krings, T, Armstrong, D, et al. Predicting factors for the follow-up outcome and management decisions in vein of Galen aneurysmal malformations. Childs Nerv Syst 2010; 26: 35–46.Google Scholar
9. Frawley, GP, Dargaville, PA, Mitchell, PJ, et al. Clinical course and medical management of neonates with severe cardiac failure related to vein of Galen malformation. Arch Dis Child Fetal Neonatal Ed 2002; 87: F144–F149.Google Scholar