Neonatal Congestive Heart Failure Due to a Subclavian Artery to Subclavian Vein Fistula Diagnosed by Noninvasive Procedures


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Abstract

Congestive heart failure in the neonate is usually due to intracardiac anomalies or cardiac dysfunction. Extracardiac causes are rare.PatientWe report a newborn infant who presented with respiratory distress and cardiomegaly.ResultEchocardiography identified a dilated right subclavian artery and vein and superior vena cava. Magnetic resonance imaging confirmed a subclavian artery to subclavian vein fistula that was treated with surgical ligation. The infant recovered fully. This case underscores the need for clinical suspicion of fistulous connection in unusual locations in the face of unexplained heart failure in the neonate.ConclusionEchocardiographic and magnetic resonance imaging are effective noninvasive modalities to confirm the diagnosis prior to surgical intervention.

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