Research Article


DOI :10.26650/jchild.2021.1.868115   IUP :10.26650/jchild.2021.1.868115    Full Text (PDF)

Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns

Muhammet BulutDilek Küçük AlemdarKıvanç ÇelikkalkanEmine TekinÖzge ErenHandan Ayhan AkoğluAzime Bulutİlknur Okur AkşanSeyyit Bahaettin Öncü

Objective: We aimed to consider Galen vein aneurysm(GVA) in cases that may often get a diagnosis later due to the pre-diagnoses of transient tachypnea of newborn and congenital heart disease accompanied by moderate-severe pulmonary hypertension in the postpartum period. 

Method: The study included cases that were followed and treated with the diagnosis of GVA in our clinic between 2016-2020. Types of delivery, week of delivery, birthweight/height/head circumference, medical treatments, and imagings were recorded from patient files. The risk evaluation was performed according to Bicetre and the scoring was recorded. 

Results: Of our cases; 80% (n=4) were female, and 80% (n=4) had been delivered via spontaneous vaginally. Their week of delivery was 39.20±.83 (min:38, max:40), birth weight was 3488±415 gr, head circumference was 36.20±1.30 and height was 51.20±1.30 cm. Firstly, all cases had tachypnea, dyspnea, cyanosis, and tachycardia. Of our cases, three were intubated, others (4.5) received non-invasive support only. The patient (infant 3) with a lower Bicetre score did not stabilize and died. One of our cases (infant 4) whose Bicetre score was above 12, was operated electively. In all cases the GVA was accompanied by persistent pulmonary hypertension (PPHT). The cases that had severe PPHT and did not improve despite inotrop treatment died. 

Conclusion: Galen vein aneurysms should certainly be considered in PPHT cases in the early stage of those that don’t respond to multiple treatment options.

DOI :10.26650/jchild.2021.1.868115   IUP :10.26650/jchild.2021.1.868115    Full Text (PDF)

Yenidoğanda Pulmoner Hipertansiyon ve Galen Ven Anevrizması Birlikteliği

Muhammet BulutDilek Küçük AlemdarKıvanç ÇelikkalkanEmine TekinÖzge ErenHandan Ayhan AkoğluAzime Bulutİlknur Okur AkşanSeyyit Bahaettin Öncü

Amaç: Doğum sonrası süreçte sıklıkla yenidoğan geçici taşipnesi ve konjenital kalp hastalığı ön tanıları nedeniyle geç tanı alabilen ve orta-ağır pulmoner hipertansiyonun eşlik ettiği vakalarda Galen ven anevrizması (GVA) riskine dikkat çekmeyi amaçladık. 

Yöntem: GVA tanısıyla merkezimizde takip ve tedavisi yapılan vakalar çalışmaya alındı. Vakaların doğum şekli, doğum haftası, doğum boy-kilo-baş çevresi, yapılan medikal tedaviler ve görüntülemeler hasta dosyasından kaydedildi. Bicetre skoruna göre yapılan risk değerlendirmesi kaydedildi. 

Bulgular: Vakalarımızın %80’i kız (n=4) olup, %80’i (n=4) spontan vajinal yol ile doğurtuldu. Doğum haftaları 39,20±0,83 (min:38, max:40) hafta, ağırlıkları 3488±415 (min:2820, max:3800) gr, baş çevreleri 36,20±1,30 (min:34, max:37) cm, doğum boyları 51,20±1,30 (min:50, max:52) cm idi. Vakalarımızın tümünün ilk fizik muayenesinde taşipne, inlemeli solunum, siyanoz ve taşikardi mevcut idi. Vakalarımızdan 3’ü entübe edilerek mekanik ventilatör desteği başlanan hastalar olup, 2 tanesi (bebek 4,5) sadece non-invaziv destek aldı. Bicetre skoru düşük olan hasta (bebek 3) erken dönemde tüm tedavilere rağmen stabilleşmedi ve eksitus oldu. Bicetre skoru 12’nin üzerinde olan vakalarımızdan birine (bebek 4) elektif şartlarda cerrahi uygulandı. Tüm vakalarımızda Galen ven anevrizmasına persistan pulmoner hipertansiyon (PPHT) eşlik etti. Vakalarımızdan ikisinde (bebek4-5) hafif-orta, diğer vakalarımızda ağır PHT gelişti. Ağır PPHT’u olan ve inotrop tedaviye rağmen düzelmeyen ve klinik olarak stabilleşmeyen vakalarımız (bebek 1-2) eksitus oldu.

Sonuç: Medikal tedaviye rağmen düzelmeyen PPHT vakalarında çoklu tedavi seçeneklerine başvurmadan, erken aşamada GVA mutlaka akılda tutulmalıdır.



PDF View

References

  • 1. Casasco A, Lylyk P, Hodes JE, Kohan G, Aymard A, Merland JJ. Percutaneous transvenous catheterization and embolization of vein of Galen aneurysms. Neurosurgery 1991;28:260-6. google scholar
  • 2. Marques RM, Lobão CA, Sassaki VS, Aguiar LR. Vein of Galen aneurysm in an adult: case report. Arq Neuropsiquiatr 2006Sep;64(3B):862-4. google scholar
  • 3. Lasjaunias P, Hui F, Zerah M, Garcia-Monaco R, Malherbe V, Rodesch G, et al. Cerebral arteriovenous malformations in children: management of 179 consecutive cases and review of the literature. Childs Nerv Syst 1995;11: 66-79. google scholar
  • 4. Deloison B, Chalouhi GE, Sonigo P, Zerah M, Millischer AE, Dumez Y, et al. Hidden mortality of prenatally diagnosed vein of Galen aneurysmal malformation: retrospective study and review of the literature. Ultrasound Obstet Gynecol 2012;40:652-8. google scholar
  • 5. Frawley GP, Dargaville PA, Mitchell PJ, Tress BM, Loughnan P. 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
  • 6. Puthiyachirakkal M, Mhanna MJ. Pathophysiology, management, and outcome of persistent pulmonary hypertension of the newborn: a clinical review. Front Pediatr 2013;1:23. google scholar
  • 7. Hilgendorff A, Apitz C, Bonnet D, Hansmann G. Pulmonary hypertension associated with acute or chronic lung diseases in the preterm and term neonate and infant. The European Paediatric Pulmonary Vascular Disease Network, end or sed by ISHLT and DGPK. Heart 2016;102(Suppl2):ii49-56. google scholar
  • 8. Walsh-Sukys MC, Tyson JE, Wright LL, Bauer CR, Korones SB, Stevenson DK, et al. Persistent pulmonary hypertension of the newborn in the era before nitricoxide: practice variation and outcomes. Pediatrics 2000;105(1 Pt 1):14-20. google scholar
  • 9. Lakshminrusimha S, Keszler M. Persistent Pulmonary Hypertension of the Newborn. Neoreviews 2015;16(12):680-92. google scholar
  • 10. Weisz DE MP. Cardiovascular Assessment. In: Goldsmith J KE, Suresh G, Keszler M. editors. Assisted Ventilation of the Neonate. Sixth ed. Philadelphia: Elsevier; 2017. google scholar
  • 11. Bendapudi P, Rao GG, Greenough A. Diagnosis and management of persistent pulmonary hypertension of the newborn. Paediatr Respir Rev 2015;16(3):157-61. google scholar
  • 12. Garcia-Monaco R, De Victor D, Mann C, Hannedouche A, Terbrugge K, Lasjaunias P. Congestive cardiac manifestations from cerebrocranial arteriovenous shunts: endovascular management in 30 children. Childs Nerv Syst 1991;7:48-52. google scholar
  • 13. Su W, Hsieh W, Chou H, Peng S, Yao Y, Won S, et al. Persistent pulmonary hypertension in a neonate with vein of Galen arteriovenous malformation. J Formos Medical Association 2005;104(9):670-3. google scholar
  • 14. Dahdah N, Alesseh H, Dahms B, Saker F. Severe pulmonary hypertensive vascular disease in two newborns with aneurysmal vein of Galen. Pedatric Cardiology 2001;22:538-41. doi: 10.1007/s002460010294.  google scholar
  • 15. D’Alto M, Romeo E, Argiento P, Di Salvo G, Badagliacca R, Cirillo AP, et al. Pulmonary arterial hypertension: the key role of echocardiography. Echocardiography. 2015;32 Suppl 1:S23-37. google scholar
  • 16. Bendapudi P, Rao GG, Greenough A. Diagnosis and management of persistent pulmonary hypertension of the newborn. Paediatr Respir Rev 2015;16(3):157-61. google scholar
  • 17. Raybaud CA, Strother CM, Hald JK. Aneurysms of the vein of Galen: embryonic considerations and anatomical features relating to the pathogenesis of the malformation. Neuroradiology 1989;31:109-28. google scholar
  • 18. Jones BV, Bal WS, Tomsick TA, Millard J, Crone KR. Vein of Galen aneurysmal malformation: diagnosis and treatment of 13 children with extended clinical follow-up. AJNR 2002;23:1717-24. google scholar
  • 19. Chevret L, Durand P, Alvarez H, Lambert V, Caeymax L, Rodesch G, 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;28:1126-30. google scholar
  • 20. Golombek SG, Ally S, Woolf P K. A newborn with cardiac failure secondary to a large vein of Galen malformation. South Med J 2004;97:516-8. google scholar
  • 21. Mitchell PJ, Rosenfeld JV, Dargaville P, Loughnan P, Ditchfield MR, Frawley G, et al. Endovascular management of vein of Galen aneurysmal malformation spresenting in the neonatal period. AJNR Am J Neuroradiol 2001;22:1403-9. google scholar
  • 22. Lasjaunias PL, Chng SM, Sachet M, Alvarez H, Rodesch G, Garcia-Monaco R. The management of vein of Galen aneurysmal malformations. Neurosurgery 2006;59:184-94. google scholar
  • 23. Jones BV, Ball WS, Tomsick TA, Millard J, Crone KR. Vein of Galen aneurysmal malformation: diagnosis and treatment of 13 children with extended clinical follow-up. AJNR 2002.23.1717-24. google scholar
  • 24. Osborn AG. Intracranial vascular malformations. In: Diagnostic Neuroradiology Mosby, 1994.p284-329. google scholar
  • 25. Rodesch G, Hui F, Alvarez H, Tanaka A, Lasjaunias P: Prognosis of antenatally diagnosed vein of Galen aneurysmal malformations. Childs Nerv Syst 1994;10:79-83. google scholar
  • 26. Saliou G, Vraka I, Teglas JP, Senat MV, Durand P, Colmant C, et al. Pseudofeeders on fetal magnetic resonance imaging predict outcome in vein of Galen malformations. Ann Neurol 2017;81(2):278-86. google scholar
  • 27. Tiwary S, Geethanath RM, Abu-Harb M. Vein of Galen malformation presenting as persistent pulmonary hypertension of newborn. BMJ Case Reports 2013;2013. google scholar
  • 28. Mathews AZ, Ibhanesebhor S, Richens T, Manjunatha CM. Heart failure in the newborn; vein of Galen aneurysmal malformation. BMJ Case Reports 2013;2013. google scholar
  • 29. Bozkaya D, Çelik HT, Arat A, Yiğit Ş, Yurdakök M. Yenidoğan Döneminde Kalp Yetmezliği Bulguları ile Seyreden Arterio-Venöz Malformasyon; Galen Ven Anevrizması. Jinekoloji-Obstetrik ve Neonatoloji Tıp Derg 2018;15(3):120-4. google scholar
  • 30. Mortazavi MM, Griessenauer CJ, Foreman P, Reza BS, Mohammadali MS, Curtis JR, et al. Vein of Galen aneurysmal malformations: critical analysis of the literature with proposal of a new classification system. J Neurosurg Pediatr 2013;12(3):293–306. google scholar
  • 31. Fullerton HJ, Aminoff AR, Ferriero DM, Gupta N, Dowd CF. Neurodevelopmental outcome after endovascular treatment of vein of Galen malformations. Neurology 2003;61:1386-90. google scholar
  • 32. Geibprasert S, Krings T, Armstrong D, Terbrugge KG, Raybaud CA. 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
  • 33. Ashida Y, Miyahara H, Sawada H, Mitani Y, Maruyama K. Anesthetic management of a neonate with vein of Galen aneurismal malformations and severe pulmonary hypertension. Pediatr Anaesth 2005;15:525-8. google scholar
  • 34. Erdoğan İA, Uluğ MH, Çizmeli MO. Galen veni anevrizmalarının tedavisinde yeni bir seçenek: transtorküler embolizasyon. Türk Nöroşirurji Dergisi 1989;1:25-30. google scholar
  • 35. Tekşam Ö, Çekirge S, Yiğit Ş, Karagöz T, Yurdakök M. Bir yenidoğanda ağır kalp yetmezliğine neden olan Galen ven anevrizmasının transumblikal yolla embolizasyonu. Çocuk Sağlığı ve Hastalıkları Dergisi 2005;48:168-74. google scholar

Citations

Copy and paste a formatted citation or use one of the options to export in your chosen format


EXPORT



APA

Bulut, M., Küçük Alemdar, D., Çelikkalkan, K., Tekin, E., Eren, Ö., Ayhan Akoğlu, H., Bulut, A., Okur Akşan, İ., & Öncü, S. (2021). Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns. Journal of Child, 21(1), 26-33. https://doi.org/10.26650/jchild.2021.1.868115


AMA

Bulut M, Küçük Alemdar D, Çelikkalkan K, Tekin E, Eren Ö, Ayhan Akoğlu H, Bulut A, Okur Akşan İ, Öncü S. Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns. Journal of Child. 2021;21(1):26-33. https://doi.org/10.26650/jchild.2021.1.868115


ABNT

Bulut, M.; Küçük Alemdar, D.; Çelikkalkan, K.; Tekin, E.; Eren, Ö.; Ayhan Akoğlu, H.; Bulut, A.; Okur Akşan, İ.; Öncü, S. Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns. Journal of Child, [Publisher Location], v. 21, n. 1, p. 26-33, 2021.


Chicago: Author-Date Style

Bulut, Muhammet, and Dilek Küçük Alemdar and Kıvanç Çelikkalkan and Emine Tekin and Özge Eren and Handan Ayhan Akoğlu and Azime Bulut and İlknur Okur Akşan and Seyyit Bahaettin Öncü. 2021. “Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns.” Journal of Child 21, no. 1: 26-33. https://doi.org/10.26650/jchild.2021.1.868115


Chicago: Humanities Style

Bulut, Muhammet, and Dilek Küçük Alemdar and Kıvanç Çelikkalkan and Emine Tekin and Özge Eren and Handan Ayhan Akoğlu and Azime Bulut and İlknur Okur Akşan and Seyyit Bahaettin Öncü. Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns.” Journal of Child 21, no. 1 (Nov. 2024): 26-33. https://doi.org/10.26650/jchild.2021.1.868115


Harvard: Australian Style

Bulut, M & Küçük Alemdar, D & Çelikkalkan, K & Tekin, E & Eren, Ö & Ayhan Akoğlu, H & Bulut, A & Okur Akşan, İ & Öncü, S 2021, 'Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns', Journal of Child, vol. 21, no. 1, pp. 26-33, viewed 15 Nov. 2024, https://doi.org/10.26650/jchild.2021.1.868115


Harvard: Author-Date Style

Bulut, M. and Küçük Alemdar, D. and Çelikkalkan, K. and Tekin, E. and Eren, Ö. and Ayhan Akoğlu, H. and Bulut, A. and Okur Akşan, İ. and Öncü, S. (2021) ‘Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns’, Journal of Child, 21(1), pp. 26-33. https://doi.org/10.26650/jchild.2021.1.868115 (15 Nov. 2024).


MLA

Bulut, Muhammet, and Dilek Küçük Alemdar and Kıvanç Çelikkalkan and Emine Tekin and Özge Eren and Handan Ayhan Akoğlu and Azime Bulut and İlknur Okur Akşan and Seyyit Bahaettin Öncü. Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns.” Journal of Child, vol. 21, no. 1, 2021, pp. 26-33. [Database Container], https://doi.org/10.26650/jchild.2021.1.868115


Vancouver

Bulut M, Küçük Alemdar D, Çelikkalkan K, Tekin E, Eren Ö, Ayhan Akoğlu H, Bulut A, Okur Akşan İ, Öncü S. Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns. Journal of Child [Internet]. 15 Nov. 2024 [cited 15 Nov. 2024];21(1):26-33. Available from: https://doi.org/10.26650/jchild.2021.1.868115 doi: 10.26650/jchild.2021.1.868115


ISNAD

Bulut, Muhammet - Küçük Alemdar, Dilek - Çelikkalkan, Kıvanç - Tekin, Emine - Eren, Özge - Ayhan Akoğlu, Handan - Bulut, Azime - Okur Akşan, İlknur - Öncü, Seyyit Bahaettin. Coexistence of Pulmonary Hypertension and Galen Vein Aneurysm in Newborns”. Journal of Child 21/1 (Nov. 2024): 26-33. https://doi.org/10.26650/jchild.2021.1.868115



TIMELINE


Submitted26.01.2020
First Revision10.02.2021
Last Revision12.02.2021
Accepted20.02.2021
Published Online02.04.2021

LICENCE


Attribution-NonCommercial (CC BY-NC)

This license lets others remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.


SHARE




Istanbul University Press aims to contribute to the dissemination of ever growing scientific knowledge through publication of high quality scientific journals and books in accordance with the international publishing standards and ethics. Istanbul University Press follows an open access, non-commercial, scholarly publishing.