Endovascular Mx of vein of Galen aneurysmal malformation in
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The present case has been reported in the Annals of Pediatric Cardiology. A term baby presented on the 7th day of life in cardiogenic shock due to vein of Galen aneurysmal malformation. A successful embolization of the malformation was performed through transarterial route on day 12 of life after a period of initial stabilization.

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. There was no history of associated fever, cyanosis, or convulsions. She was intubated and mechanically ventilated in view of severe respiratory distress at the site of the first contact and then transferred to our center 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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