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      Aneurisma de la vena de Galeno como causa de falla cardíaca Translated title: Galen's vein aneurysm as cause of heart failure

      case-report

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          Abstract

          Se presenta el caso de un recién nacido que ingresa a cuidado intensivo con un cuadro de falla cardiaca de difícil manejo con ductus arterioso de gran tamaño, a quien se le realizó cierre quirúrgico del mismo y pese a ello persistía con clínica de falla cardiaca que no mejoraba con tratamiento médico. Se hizo un hallazgo incidental de un aneurisma de la vena de Galeno de gran tamaño. El aneurisma de la vena de Galeno es una patología congénita poco frecuente que se origina de un defecto en la fusión de las venas cerebrales internas, debido a la baja resistencia produce un cuadro de falla cardiaca de alto gasto. Los defectos de gran tamaño pueden contener entre 50% a 60% del gasto cardiaco. Se debe sospechar aneurisma en todo recién nacido o lactante menor con cuadro de falla cardíaca y dilatación de cavidades derechas sin evidencia de anomalía cardíaca estructural.

          Translated abstract

          We present the case of a newborn admitted to the intensive care unit with a heart failure of difficult medical management. A large ductus arteriosus was found. It was surgically corrected, but the heart failure persisted and did not improve with medical treatment. Incidentally, a big Galen's vein aneurysm was found. Galen's vein aneurysm is a rare congenital pathology, originated by a fusion defect of the internal cerebral veins. Due to its low resistance, it produces a picture of high-output heart failure. Large defects may contain 50% to 60% of cardiac output. An aneurysm may be suspected in each newborn or infant with clinical picture of heart failure and right cardiac chamber dilation without any evidence of structural cardiac anomaly.

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          Most cited references15

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          Vein of galen malformations.

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            Vein of Galen malformations: review.

            Vein of Galen malformations are unique congenital malformations of the cerebral vasculature that result in persistence and 'aneurysmal' dilatation of the venous structures. The varied clinical presentations and their distinctive and complex angioarchitecture make it important for the caring physician to understand their embryological and pathophysiological aspects. Management of these lesions--both in the neonatal period and at the time of definitive intervention, is challenging. Considering the rarity of these lesions, there are very few studies that have been able to compare the results of different techniques in the management. Continuing developments in the diagnostic as well as interventional aspects during the last two decades have radically changed the management of these lesions. Antenatal diagnosis and referral to a center with facilities for advanced neonatal cardiac care as well as for interventional neuroradiological therapy can go a long way in improving the prognosis in these children.
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              Vein of Galen malformation. Endovascular management of 43 cases.

              Since 1984, 43 patients with true vein of Galen aneurysmal malformations have been referred to us and managed according to our patient selection, technique, and follow-up guidelines. Thirty-four were embolized transarterially with bucrilate (isobutyl cyanoacrylate) or enbucrilate (N-butyl cyanoacrylate) embolization. No cutdown or hypotension during or after the embolization was used and no balloon catheter was employed. Forty-seven percent of the children had a completely occluded lesion which was confirmed when the child was at least 6 months of age at the follow-up angiographic examination; 52.9% were found to be completely normal or only to have mild cardiac failure that could be treated medically or moderate macrocephaly without neurological symptoms or mental retardation. In the embolized group 5.8% died as a result of the wrong treatment (1 case) or poor timing of embolization 3 days after ventricular shunting (1 case). The overall mortality (embolized and non-embolized groups) in the neonatal children was 27.7% with a total of 18.6% for all ages. Complete morphological exclusion of the arteriovenous malformation was accomplished in 41.9%; 74.4% of all children referred are now clinically normal or present moderate mental retardation which is diminishing. There was 3% neurological morbidity in the embolized group (only following the venous approach) in 78 sessions and more than 100 arteries embolized. These results compare favorably with surgical or other techniques of arterial embolization (balloon or particles), as well as transvenous (transtorcular or transfemoral) embolization, where the morbidity and mortality are significantly higher and the late clinical evaluation is seldom satisfactory.(ABSTRACT TRUNCATED AT 250 WORDS)
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                Author and article information

                Journal
                rcca
                Revista Colombiana de Cardiología
                Rev. Colomb. Cardiol.
                Sociedad Colombiana de Cardiologia. Oficina de Publicaciones (Bogota, Cundinamarca, Colombia )
                0120-5633
                December 2005
                : 12
                : 4
                : 163-166
                Affiliations
                [01] Bogotá orgnameClínica Abood Shaio orgdiv1Unidad de Cuidado Intensivo Pediátrico Colombia
                [02] Bogotá orgnameClínica Abood Shaio orgdiv1Cardiología Pediátrica Colombia
                Article
                S0120-56332005000600004 S0120-5633(05)01200404
                a42d58fb-a9de-4971-a11c-fe6fdd359968

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 20 May 2005
                : 12 October 2005
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 4
                Product

                SciELO Colombia

                Categories
                Cardiología pediátrica - Reporte de caso

                aneurysm,Galen's vein,heart failure,aneurisma,vena de Galeno,falla cardiaca

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