Abstract
Using the Doppler technique, this study compared the prenatal and postnatal flow patterns of an infant with cerebral arteriovenous (AV) malformation. Fetal right ventricular end-diastolic dimension was 1.7 cm with right ventricular ejection equaling 66% of the combined cardiac output. Diastolic flow was reversed in the fetal aortic isthmus but forward-moving in the descending aorta, resulting in a watershed phenomenon. In the carotid arteries an increased forward diastolic flow was noted while the internal jugular vein exhibited a pulsatile arterial type of flow. The pulsatility index of the umbilical artery was normal. After birth and closure of the ductus arteriosus, the output from both ventricles was equally increased, and retrograde diastolic flow was then observed in the descending aorta. In conclusion, specific fetal features of cerebral AV malformation are increased right ventricular output probably related to the increased superior vena cava return, watershed phenomenon in the descending aorta causing the right ventricle to perfuse both the lower and upper body, and preserved umbilical circulation.
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Allan LD, Joseph MC, Boyd EGCA, Campbell S, Tynan M (1982) M-mode echocardiography in the developing human fetus.Br Heart J 47:573–583
De Smedt MCH, Visser GHA, Meijboom EJ (1987) Fetal cardiac output estimated by Doppler echocardiography during mid- and late gestation.Am J Cardiol 60:338–342
Johnson W, Berry JM, Einzig S, Bass JL (1988) Doppler findings in nonimmune hydrops fetalis and cerebral arteriovenous malformation.Am Heart J 115:1138–1140
Musewe NN, Smallhorn JF, Burrows PE, Izukawa T, Freedom RM (1988) Echocardiographic and Doppler evaluation of the aortic arch and brachiocephalic vessels in cerebral and systemic arteriovenous fistulas.J Am Coll Cardiol 12:1529–1535
Sivakoff M, Nouri S (1982) Diagnosis of vein of Galen arteriovenous malformation by two-dimensional ultrasound and pulsed Doppler method.Pediatrics 69:84–86
Starc TJ, Krongrad E, Bierman FZ (1989) Two-dimensional echocardiography and Doppler findings in cerebral arteriovenous malformation.Am J Cardiol 64:252–254
Watson DG, Smith RR, Brann AW (1976) Arteriovenous malformation of the vein of Galen: treatment in a neonate.Am J Child Dis 130:520–525
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Patton, D.J., Fouron, JC. Cerebral arteriovenous malformation: prenatal and postnatal central blood flow dynamics. Pediatr Cardiol 16, 141–144 (1995). https://doi.org/10.1007/BF00801914
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DOI: https://doi.org/10.1007/BF00801914