Percutaneous coil embolisation of congenital hepatic arteriovenous malformations in two patients with congenital heart disease and review of the literature

Al-Ata Jameel, Arfi Muhammed Amin, Hussain Arif, Kouatli A. Amjad

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DOI: 10.4236/health.2010.28134                

Abstract

Congenital hepatic arterio-venous malformations (AVM) are rare vascular anomalies and have rarely been reported in the presence of congeni-tal heart disease. The reported cases are mostly hemangiomas fed either by the hepatic artery itself or by one of its branches. We present two unique hepatic AVM cases in the presence of congenital heart defects in which the AVM was not fed by the hepatic arterial system. Transcatheter coil embolisation was successfully carried out in both of them by using non-detachable Gianturco coils. Complete occlusion was achieved without any sequel.

Keywords

Arterio-venous Malformation; Trans-Catheter Embolisation; Congenital Heart Disease

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Gallego, C., Miralles, M., Marin, C., Muyor, P., Gonzales, G. and Garcia-Hidalgo, E. (2004) Congenital hepatic shunts. RadioGraphics, 24(3), 755-772.
[2]	Mulliken, J.B. and Glowacki, J. (1982) Hemangiomas and vascular malformations in infants and children: A classification based on endothelial characteristics. Plastic Reconstruction Surgery, 69(3), 412-422.
[3]	Shulman, R.J., Holmes, R., Ferry, G.D. and Finegold, M. (1986) Splanchnic bed vascular malformations and the development of portal hypertension. Journal of pediatric Surgery, 21(4), 355-357.
[4]	Dehner, L.P. (1978) Hepatic tumors in pediatric age group: A distinctive clinicopathologic spectrum. Pediat-ric Pathology, 4, 217-268.
[5]	Weinberg, A.G. and Finegold, M.J. (1983) Primary he-patic tumors of childhood. Human Pathology, 14(6), 512-537.
[6]	Boon, L.M., Burrows, P.E., Paltiel, H.J., Lund, D.P., Ezekowitz, R.A., Folkman, J. and MulliKen, J.B. (1996) Hepatic vascular anomalies in infancy: A 27 years ex-perience. Journal of Pediatrics, 129(3), 346-354.
[7]	Folkman, J., Mulliken, J. and Ezikowitz, A. (1997) An-giogenesis and hemangiomas, In: Oldman, K., Colom-bani, P. and Foglia, R., Eds., Surgery of infants and chil-dren. Lippincott-Raven Publishers, Philadelphia.
[8]	Mulliken, J.B. and Young, A.Y. (1988) Vascular birth-marks: hemangiomas and malformations. W. B. Saunders, Philadelphia.
[9]	Paltiel, H.J, Patriquin, H.B., Keller, M.S., Babcock, D.S. and Leithiser, R.E. (1992) Infantile hepatic hemangioma: Doppler US. Radiology, 182(3), 735-742.
[10]	Stanley, P., Geer, G.D., Miller, J.H., Gilsanz, V., Landing, B.H. and Boechat, I.M. (1989) Infantile hepatic heman-gioma: clinical features, radiological investigations, and treatment of 20 patients. Cancer, 64(4), 936-949.
[11]	Takeuchi, Y., Arai, Y., Inaba, Y., Ohno, K., Maeda, T. and Itai, Y. (1998) Extrahepatic arterial supply to the liver: Observation with a unified CT and angiography system during balloon occlusion of the proper hepatic artery. Radiology, 209(1), 121-128.
[12]	Nielsen, G. (1984) Arterio-venous malformations as a cause of congestive heart failure in the newborn and in-fant. Three cases with different haemodynamic mecha-nisms. European Journal of Paediatrics, 142(4), 298- 300.
[13]	Israel, P.G., Armstrong, B.E., Effman, E.L., Newman, G.E. and Anderson, P.W. (1993) Retroperitoneal arteriovenous malformation, a rare cause of heart failure in infancy: Consideration of therapeutic approach. Pediatric Cardi-ology, 14(1), 49-52.
[14]	Favilli, S., De Simone, L., Scarano, E., Repetto, T. and Manetti, A. (1995) Congenital arteriovenous malforma-tions: an unusual cause of heart failure at birth and dur-ing the first months of life. G Italian Cardiology, 25(7), 88-90.
[15]	Subramanyam, R., Narayan, R., da Costa, D., Derweesh, A. and Khusaiby, S.M. (2001) Transcatheter coil occlu-sion of hepatic arteriovenous malformation in a neonate. Indian Heart Journal, 53(6), 782-784.
[16]	Chavan, A., Caselitz, M., Gratz, K.F., Lotz, J., Kirchhoff, T., Piso, P., Wagner, S., Manns, M. and Glalanski, M. (2004) Hepatic artery embolisation for treatment of pa-tient with hereditary hemorrhagic telangiectasia and sym- ptomatic hepatic vascular malformations. European Ra-diology, 14(11), 2079-2085.
[17]	Costa, S., de Carolis, M.P., Di Stasi, C., Papacci, P., Fusco, F. and Romagnoli, C. (2006) Transubilical em-bolisation of hepatic arteriovenous malformation in a neonate with heart failure. European Journal of Pediat-rics, 165(11), 897-909.
[18]	Mejides, A.A., Adra, A.M., O’Sullivan, M.J. and Nicholas, M.C. (1995) Prenatal diagnosis and therapy for a fetal hepatic vascular malformation. Obstetric and Gy-necology, 85(5), 850-853.
[19]	Knudson, R.P. and Alden, E.R. (1979) Symptomatic arte-riovenous malformation in infants less than 6 months of age. Pediatrics, 64(2), 238-241.
[20]	Chavan, A., Galanski, M., Wagner, S., Caselitz, M., Schlitt, H.J., Gratz, K.F. and Manns, M. (1998) Hereditary hem-orrhagic telangiectasia: Effective protocol for embolisa-tion of hepatic vascular malformations-experience in 5 patients. Radiology, 209(3), 735-739.
[21]	Marchand, V., Uflacker, R., Baker, S.S. and Baker, R.D. (1999) Congenital hepatic arterioportal fistula in a 3- year-old child. Journal of Pediatric Gastroenterology and Nutrition, 28(4), 435-441.
[22]	Hazebroek, F.W., Tibboel, D., Robben, S.G., Bergmeyer, J.H. and Molenaar, J.C. (1995) Hepatic artery ligation for hepatic vascular tumors with arteriovenous and arterio-portal venous shunts in the newborn: successful man-agement of two cases and review of literature. Journal of Pediatric Surgery, 30(8), 1127-1130.
[23]	Whiting, J.H. Jr, Korzenik, J.R., Miller, F.J. Jr, Pollack, J.S. and White, R.I. (2000) Fatal outcome after “mbolisa-tion” for hepatic arteriovenous malformations of the liver in two patients with hereditary hemorrhagic telangiecta-sia. Journal of Vascular Interventional Radiology, 11(7), 855-858.
[24]	Chen, C.H., Yang, P.M., Sheu, J.C., Huang, G.T., Tsang, Y.M., Lee, P.H. and Chen, D.S. (1999) Intrahepatic bilo-mas associated with hepatic arteriovenous malformation. Hepatogastroenterology, 46(25), 443-447.
[25]	Alexander, C.P., Sood, B.G., Zilberman, M.V., Becker, C. and Bedard, M.P. (2006) Congenital hepatic arterioven-ous malformation: An unusual cause of neonatal persis-tant pulmonary hypertension. Journal of Perinatology, 26(5), 316-318.
[26]	Hisamatsu, K., Ueeda, M., Ando, M., Koike, K., Matsuo, N., Matsu-Ura, K., Ueda, H., Hirohata, M. and Imai, M. (2000) Peripheral arterial coil embolisation for hepatic ar-teriovenous malformation in Osler-Weber-Rendu disease; useful for controlling high output heart failure, but harmful to the liver. Internal Medicine, 38(8), 962-968.
[27]	Prokurat, A., Kluge, P., Chrupek, C., Kosciesa, A. and Rajszys, P. (2002) Hemangioma of the liver in children: Proliferating vascular tumor or congenital vascular mal-formation. Medical Pediatric Oncology, 39(5), 524-529.
[28]	Akita, H., Ohta, A., Furukawa, S., Egawa, Y., Kawahito, T., Horike, K., Ohshio, T. and Matsumura, C. (1995) Newborn with congenital arteriovenous fistula of the abdominal wall complicated by a ductus arteriosus. Pe-diatric Cardiology, 16(5), 235-238.
[29]	Burrows, P.E., Dubios, J. and Kassarjan, A. (2001) Pediat-ric hepatic vascular anomalies. Pediatric Radiology, 31(8), 533-545.
[30]	Buscarini, E., Buscarini, L., Civardi, G., Arruzzoli, S., Bossalini, G. and Piantanida, M. (1994) Hepatic vascular malformations in hereditary hemorrhagic telangiectasia: Image findings. Americam Journal of Roentgenology, 163(5), 1105-1110.