Subclavian-artery-to-innominate-vein fistula presenting with congestive failure in a newborn infant.

Congestive heart failure associated with intrathoracic arterio-venous fistula has not, to our knowledge, been reported previously in a newborn infant. A 2 X 4 mm arterio-venous fistula between the subclavian artery and innominate vein presented on the first day of life with heart failure and required surgical intervention. The uncommon location of the fistula produced potentially misleading radiologic findings. When the infant was 2 days old the fistula and a 12 mm diameter persistent ductus arteriosus were ligated; following this, heart failure regressed.