[Congenital arterio-venous malformations: an unusual cause of heart failure at birth and during the first months of life].

BACKGROUND

Congenital arteriovenous malformations represent a rare cause of heart failure in neonates.

MATERIALS

Four neonates with arteriovenous malformations (cerebral in one, hepatic in two and pulmonary in one) are reported.

RESULTS

In the first three cases Color Doppler echography was able to image the arteriovenous malformations, to identify the afferent and efferent vessels and to quantify the arteriovenous shunt. In the neonate with pulmonary malformation, a cardiac cause of heart failure was excluded by echocardiography, and the diagnosis was stated by selective angiography. The neonate with cerebral great arteriovenous malformation died at 4th day of life. The two neonates with hepatic malformations improved both with medical therapy; in the last neonate, with multiple arteriovenous pulmonary fistulae, selective embolization was performed, but the child died a few months later.

CONCLUSION

Congenital arteriovenous malformations are rare, and an early diagnosis is the base for a correct therapy; Color Doppler echography represents the gold standard for cerebral and hepatic malformations, while selective angiography should be reserved to patients who might profit of embolization or surgical resection.