Abstract
Vein of Galen malformation (VOGM) is a congenital, intracranial vascular malformation,
with an extracardiac shunt. Neonates can present with high output cardiac failure,
pulmonary hypertension, or multiorgan failure and are at high risk of perioperative
complications, especially in remote locations. We conducted a retrospective single-center
analysis of the perioperative management of patients with VOGM presenting for embolization.
Patients were identified by querying both the hospital billing dataset using International
Classification of Diseases-10 diagnosis or billing code and the Neuro-interventional
Radiology Database, from January 2011 to March 2020. As many as 14 patients were identified,
12 of which underwent definitive treatment. Six patients who underwent embolization
in the neonatal period had pulmonary hypertension. Those children required varying
degrees of hemodynamic and respiratory support preoperatively and experienced significant
intraoperative events, including one intraoperative cardiac arrest. Caring for these
critically ill patients in a remote location requires proper planning to prevent adverse
outcomes.
Keywords
intraoperative - pulmonary hypertension - vein of Galen malformation
