Yenidoğanda Ciddi Kalp Yetersizliğinin Nadir Bir Nedeni: Galen Ven Malformasyonu

Year 2015, Volume: 12 Issue: 1, 146 - 150, 15.04.2015

Ali Yildirim , Savaş Demirpençe Bülent Koca Hasan Tolga Çelik Sena Ünverdi

Abstract

Galen ven anevrizmal malformasyonu 1/25000 canlı doğumda görülen, yenidoğan döneminde ciddi
mortalite ve morbidite ile seyreden, intrakraniyal anevrizmadır. Yenidoğanda genellikle yüksek debili kalp
yetersizliği ve pulmoner hipertansiyon bulgularıyla karşımıza çıkmaktadır. Postnatal ilk gününde solunum
sıkıntısı ve siyanoz nedeniyle yoğun bakım ünitesine yatırılan erkek bebekte pulmoner hipertansiyon tespit
edilmiş. Magnezyum sulfat ve fosfodiesteraz inhibitörü başlanan hastada multiorgan yetersizliği gelişmesi
nedeniyle tarafımıza yönlendirildi. Pulmoner hipertansiyon tespit edilen hastanın inen aortasında diyastolik
ters akım saptanması nedeniyle yapılan kraniyal ultrasonografide galen ven anevrizması tespit edildi.
İlerleyici kalp yetersizliği ve pulmoner hipertansiyon ile başvuran postnatal 20 günlük erkek bebekte tespit
edilen galen ven anevrizma vakasını sunduk.

Keywords

Yenidoğan, kalp yetersizliği, Galen Ven Malformasyonu

Neonate With Severe Heart Failure Related To Vein Of Galen Malformation

Abstract

Vein of Galen aneurysmal malformation is a type of intracranial anerysm occurring in 1/25000 live-births
that is characterized by significant morbidity and mortality during the newborn period. Newborns with this
condition generally present with high-output cardiac failure and pulmonary hypertension. A male infant
admitted to the intensive care unit on postnatal day 1 due to respiratory distress and cyanosis was found to
have pulmonary hypertension. Treatment with magnesium sulfate and phosphodiesterase inhibitor was
administered. However, due to the development of multiorgan failure, the patient was referred to our unit.
Pulmonary hypertension was confirmed and diastolic reverse flow was detected in the descending aorta. A
subsequent cranial ultrasound examination showed the presence of Galen vein aneurysm. Herein, a 20-day
old male patient presenting with progressive cardiac failure as well as pulmonary hypertension who was
diagnosed to have Galen vein aneurysm is described

Keywords

Neonate, heart failure, malformation of Galen Vein

References

• 1. Gailloud P, O'Riordan DP, Burger I, Levrier O, Jallo G, Tamargo RJ et al. Diagnosis and management of vein of Galen aneurysmal malformations. J Perinatol. 2005; 25(8): 542-51. 2. Mickle JP, Mericle RA, Burry MV, Williams LS: Vein of Galen malformations, in Winn RH: Youmans Neurological Surgery, Vol 3. Philadelphia: Saunders, 2004, p 3433. 3. Sasidharan CK, Anoop P, Vijayakumar M, Jayakrishnan MP, Reetha G, Sindhu TG. Spectrum of clinical presentations of vein of Galen aneurysm. Indian J Pediatr. 2004;71(4): 459-63. 4. Chen MY, Liu HM, Weng WC, Peng SF, Wu ET, Chiu SN. Neonatewithsevereheart failurerelatedtovein of Galen malformation. Pediatr Neonatol. 2010; 51(4): 245- 8. 5. Gupta AK, Varma DR. Vein of Galen malformations: review. Neurol India. 2004; 52(1): 43–53. 6. Karadeniz L, Coban A, Sencer S, Has R, Ince Z, Can G. Vein of Galen aneurysmal malformation: prenatal diagnosis and early endovascular management. J Chin Med Assoc. 2011; 74(3): 134-7. 7. Pellegrino PA, Milanesi O, Saia OS, Carollo C. Congestive heart failure secondary to cerebral arteriovenous fistula. Childs Nerv Syst. 1987; 3(3): 141–4. 8. Nuutila M, Saisto T. Prenatal diagnosis of vein of Galen malformation: a multidisciplinary challenge. Am J Perinatol. 2008; 25(4): 225-7. 9. Jordan L, Raymond G, Lin D, Gailloud P. CT angiography in a newborn child with hydranencephaly. J Perinatol. 2004; 24(9): 565-7. 10. Gupta AK, Rao VR, Varma DR, Kapilamoorthy TR, Kesavadas C et al. Evaluation, management, and long-term follow up of vein of Galen malformations. J Neurosurg. 2006: 105(1): 26–33.