Endovascular Mx of vein of Galen aneurysmal malformation in
The present case has been reported in the Annals of Pediatric Cardiology. Vein of Galen aneurysmal malformations (VGAMs) are rare congenital vascular malformations that may present with high-output cardiac failure and multiorgan dysfunction in the newborn period.

The authors report a case of a neonate who had presented with cardiogenic shock due to a VGAM and was salvaged with emergency endovascular embolization. The purpose of this report is to highlight the above-mentioned nuances that are vital to save such babies.

A term baby was born by cesarean section in good condition with a birth weight of 3 kg. The baby had been antenatally diagnosed with VGAM by fetal magnetic resonance imaging (MRI) done at 32 weeks of gestation. Unfortunately, despite the intrauterine diagnosis, the baby was sent home after delivery.

The child remained asymptomatic for the first 5 days of life. At 6 days of age, she developed acute onset respiratory distress followed by poor feeding and lethargy. She was intubated and mechanically ventilated in view of severe respiratory distress at the site of the first contact and then transferred for further management.

On examination, she was found to be in shock with prolonged capillary refill time, tachycardia, mottling of the skin, cool extremities, and decreased urine output since the onset of symptoms. Arterial oxygen saturation was 98% on complete ventilatory support. The cardiovascular examination was notable for the presence of a third heart sound with normal splitting of the second heart sound.

No murmur was heard. All peripheral pulses were poorly felt. There was no difference in pulses in upper and lower limbs. Gross hepatomegaly was present. The anterior fontanelle was open and pulsatile; however, no cranial bruit could be heard. There were no dysmorphic features and the other systemic examination was unremarkable.

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