Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T21:07:24.375Z Has data issue: false hasContentIssue false
  • English
  • Français

Targeted neonatal echocardiography-guided therapy pre-embolisation for congenital hepatic vascular malformation: inhaled nitric oxide to prevent paradoxical embolisation to the systemic circulation

Published online by Cambridge University Press:  16 November 2020

Adrianne R. Bischoff Open the ORCID record for Adrianne R. Bischoff [Opens in a new window] ,
Patrick J. McNamara  and
Regan E. Giesinger
Adrianne R. Bischoff
Affiliation:
Department of Paediatrics, University of Iowa, Iowa City, IA, USA
Patrick J. McNamara
Affiliation:
Department of Paediatrics, University of Iowa, Iowa City, IA, USA Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
Regan E. Giesinger*
Affiliation:
Department of Paediatrics, University of Iowa, Iowa City, IA, USA
*
Author for correspondence: R. E. Giesinger, MD, BScH, FRCPC, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242, USA. Tel: +1 319 467 7435; Fax: +1 319 356-4685.E-mail: regan-giesinger@uiowa.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Arteriovenous malformations may present with significant haemodynamic compromise in the neonatal period, typically with high output cardiac failure that may be accompanied by hypoxia and right ventricular dysfunction. Targeted neonatal echocardiography performed by trained neonatologists provides an enhanced physiology-based approach that can guide treatment and minimise complications. We present a case of a large hepatic vascular malformation whose therapy was guided by targeted neonatal echocardiography to prevent paradoxical embolisation of procedural glue to the systemic circulation.

Keywords

Targeted neonatal echocardiographyarteriovenous malformationinhaled nitric oxideembolisationpulmonary hypertension
Type
Brief Report
Information
Cardiology in the Young , Volume 31 , Issue 2 , February 2021 , pp. 308 - 311
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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

Paley, MR, Farrant, P, Kane, P, Heaton, ND, Howard, ER, Karani, JB. Developmental intrahepatic shunts of childhood: radiological features and management. Eur Radiol 1997; 7: 1377–1382.CrossRefGoogle ScholarPubMed
Steinhorn, RH, Russell, JA, Lakshminrusimha, S, Gugino, SF, Black, SM, Fineman, JR. Altered endothelium-dependent relaxations in lambs with high pulmonary blood flow and pulmonary hypertension. Am J Physiol Heart Circ Physiol 2001; 280: H311–H317.CrossRefGoogle ScholarPubMed
Wu, L, Zhao, L, Lu, Y, He, L, Hu, X. Interventional embolization of congenital intrahepatic shunts in children. Pediatr Radiol 2016; 46: 541–547.CrossRefGoogle ScholarPubMed
Giesinger, RE, Elsayed, YN, Castaldo, MP, McNamara, PJ. Targeted neonatal echocardiography-guided therapy in vein of galen aneurysmal malformation: a report of two cases with a review of physiology and approach to management. AJP Rep 2019; 9: e172–e176.Google Scholar
Bouras, AF, Truant, S, Beregi, JP, et al. Atrial embolism caused by portal vein embolization: treatment by percutaneous withdrawal and stenting. World J Hepatol 2012; 4: 412–414.CrossRefGoogle ScholarPubMed
De Luca, D, Piastra, M, Pietrini, D, Rollo, M, Conti, G. “Glue lung”: pulmonary micro-embolism caused by the glue used during interventional radiology. Arch Dis Child 2008; 93: 263.10.1136/adc.2007.134445CrossRefGoogle ScholarPubMed
Abbar, B, Vimpere, D, Khater, S, Cellier, C, Diehl, JL. Cerebral infarction following cyanoacrylate endoscopic therapy of duodenal varices in a patient with a patent foramen ovale. Intern Emerg Med 2018; 13: 817–819.CrossRefGoogle Scholar
Giesinger, RE, Stanford, AH, Rios, DR et al. Targeted neonatal echocardiography in the United States of America: the contemporary perspective and challenges to implementation. Pediatr Res 2019.CrossRefGoogle Scholar
Ashraf, P, Haqqi, SA, Shaikh, H, Wakani, AJ. Glue embolism: a rare cause of pulmonary embolism. J Coll Physicians Surg Pak 2011; 21: 574–576.Google ScholarPubMed
Abdullah, A, Sachithanandan, S, Tan, OK, et al. Cerebral embolism following N-butyl-2-cyanoacrylate injection for esophageal postbanding ulcer bleed: a case report. Hepatol Int 2009; 3: 504–508.CrossRefGoogle ScholarPubMed
Supplementary material: Image

Bischoff et al. supplementary material

Bischoff et al. supplementary material

Download Bischoff et al. supplementary material(Image)
Image 147.8 KB